Sign-Out
Effective hand-offs must occur to ensure continuous high-quality care for our patients regardless of the time of day and what physicians are covering the patients.
Principles of error free handoffs
Communicate interactively, allowing and promoting questions
Communicate up-to-date information: treatment, services, condition, and recent or anticipated changes.
Limit interruptions
Allow sufficient time
Require a verification process: repeat-backs
Ensure the receiver has the opportunity to review data
Handoff document
Supplement verbal handoff
Allows receiver to follow along
Provides more comprehensive info
To include: Name/MR#/Location/Code status/ Attending name/Resident name/Team Contact/Family contact info
Active meds/ Current pt condition/Active clinical issues/Anticipated issues and what to do (If-Then guidance)/To-do List/To follow-up list
Prepared by patient’s primary provider for the day
Supervisor should ensure quality
Incorporate time for review and updating into daily workflow
Key Features:
Succinct
Specific (if/then)
Accurate
Up to date
Updating Sign-out in EPIC
Click ‘Write Handoff’ button in the Epic Toolbar once patient is selected
There are 3 sections:
Summary
Dot phrase for Summary is .sosummary
List one liner and relevant interventions completed in HPI
List active issues that are medically concerning or covering resident will be paged about.
Keep it concise and relevant
List pertinent positive or negative exam findings
List relevant events from the day (hemodynamic instability, trach/PEG, etc)
Situational Awareness
Dot phrase for Situational Awareness is .sositawareness
List only items for NF to follow up on that will change management emergently
Do not feel the need to list something if nothing is relevant
Provide guidance for possible events that could happen in If/Then:
Action List
Couple words to describe reason for admission
Neurology Hand-off process
Face-to-face hand-off occurs at the change of shift as follows:
4:30-5:30 PM in the Neurology Library – The Short Call resident will be available for verbal sign-out. The Stroke and General Team residents will continue to cover the pagers during this time so the hand-off is not interrupted.
8:30 PM: The Short-Call resident will hand-off to the Night Float resident in the Stroke Team Room
07:00 AM: The Night Float resident will be in the Library to hand-off back to the day team residents. Any overnight events will be reported back to the day teams in the morning.
Significant overnight events (e.g. called to see the patient for change in exam) should also be documented by the covering resident with a quick Progress Note in EPIC.
Last Updated: June 14, 2019