Provider Communications at Shift Change
Course Description
Presenter: Leora Horwitz, MD, MHS
The Yale Section of General Internal Medicine
This course will cover something that happens at least twice a day in every hospital and care center across the United States; the communication that occurs at shift change when handing off the care of a patient from one caregiver to another.
Conveying a clear, concise picture of a patient’s current state to an oncoming clinician is not easy. Uncertainty, omissions, delays must be constantly guarded against. A fumbled handoff can lead to real adverse consequences for that patient.
This course will examine communications and sign-out from many perspectives.
Time to view this course is 22 minutes.
Course Learning Objectives
At the conclusion of this course the learner will understand:
- How prevalent adverse events are today
- Accreditation Council for Graduate Medical Education (ACGME) requirements for hand-offs
- The four categories for handoff problems
- What information is needed at sign-out
- The SIGNOUT structure
- The 7 ‘C’s’ of good sign-out language
Time to complete this course is approximately 50 minutes.
Presenter: Leora Horwitz, MD, MHS
Leora Horwitz, MD is a general internist who studied social science as an undergraduate and is now a clinician-researcher focused on quality and safety in healthcare. In particular, she focuses on systems and practices intended to bridge gaps or discontinuities in care. She has studied shift-to-shift transfers among physicians and among nurses, transfers from the emergency department to inpatient units, and the transition from the hospital to home. Her current work is focused primarily on the transition from hospital to home. These studies range from a prospective cohort study of older patients discharged home from Yale to a large administrative dataset study of national readmission rates. Dr. Horwitz founded and chairs the Transfers and Handoffs Interest Group at the Society of General Internal Medicine and has advised the Hospital to Home (H2H) Excellence in Transitions program. Finally, as a member of Yale-New Haven Hospital’s Performance Management group and co-chair of Yale-New Haven Hospital’s Readmission Committee and Handoff Committee, she has direct operational responsibility for improving handoffs throughout the institution.
Developing Organization: The Yale Section of General Internal Medicine
The Department of Internal Medicine at Yale is among the nation’s premier departments, bringing together an elite cadre of clinicians, investigators, and educators in one of the world’s top medical schools.
The Department has 327 full-time faculty members and a voluntary faculty of 506, and its training ranks include 383 residents and fellows. Among the faculty are four members of the Institute of Medicine, 17 members of the Association of American Physicians, and 23 members of the American Society for Clinical Investigation. The Department is embedded in a remarkable basic science environment at Yale, with a collaborative culture that affords numerous opportunities for interdisciplinary and translational research