Resident Handover: Need for Structured Curriculum and Quality Outcome Studies

Objective: The aim of this study was to investigate the efficacy of a structured handoff curriculum to increase competency and efficiency at handoff, improve resident perception of handoff, and impact patient outcomes. Methods: Trained faculty assessed residents (n = 15) at a single center using a validated evaluation tool measuring the following: organization/efficiency, communication skills, content, clinical judgment, and humanistic qualities/professionalism, before and after the implementation of the standardized verbal handover tool, SAFETIPS [1]. A nonvalidated faculty observation tool was utilized to evaluate residents’ ability to prioritize and organize verbal handoff. Residents completed a qualitative survey evaluating perceptions of handover. Patient outcome parameters were measured before and after implementation of the handover curriculum. Results: All faculty ratings of resident handoff significantly improved, with mean changes ranging from 1.2 to 1.9 points (p < 0.05 for all questions, n = 11). Using matched data, handover times in minutes per patient did not change significantly. Average scores from the nonvalidated questions improved to 0.45 (n = 11, p = 0.24, CI = −0.36–1.27). Pre- and post-intervention periods did not differ significantly on the rates of patient outcome parameters. Residents reported the standardized handover system made verbal handover more concise, complete, and accurate. Conclusions: Formalized handover curriculum significantly improved key areas of resident handover including organization/efficiency, communication skills, content, clinical judgment, and humanistic qualities/professionalism but failed to show improvements in selected objective patient outcome measures.