Using a Direct Observation Tool (TOC-CEX) to Standardize Transitions of Care by Residents at a Community Hospital

Increases in Ascension Providence Rochester Hospital residents’ awareness of handoff mechanism and required mnemonic from 2016-2019. The dashed line represents the percentage of yes responses to question 1, “Does your program have a mechanism for monitoring handoffs?” The solid line represents the percentage correctly identifying the SAIF-IR mnemonic (summary, active issues, if-then contingency planning, follow-up activities, interactive questioning, readback) for question 2, “Does your program endorse a specific mnemonic for organizing the contents of a verbal handoff?” Source: Graduate medical education resident surveys 2016-2019. TOC-CEX, Transitions of Care-Clinical Evaluation Exercise.