Shaughnessy Erin E, Ginsbach Kimberly, Groeschl Nicole, Bragg Dawn, Weisgerber Michael
J Grad Med Educ. 2013 Mar;5(1):150-3. doi: 10.4300/JGME-D-12-00139.1.
The Accreditation Council for Graduate Medical Education requires residency programs to ensure safe patient handovers and to document resident competency in handover communication, yet there are few evidence-based curricula teaching resident handover skills.
We assessed the immediate and sustained impact of a brief educational intervention on pediatrics intern handover skills.
Interns at a freestanding children's hospital participated in an intervention that included a 1-hour educational workshop on components of high-quality handovers, as well as implementation of a standardized handover format. The format, SAFETIPS, includes patient information, current diagnosis and assessment, patient acuity, a focused plan, a baseline exam, a to-do list, anticipatory guidance, and potential pointers and pitfalls. Important communication behaviors, such as paraphrasing key information, were addressed. Quality of intern handovers was evaluated using a simulated encounter 2 weeks before, 2 weeks after, and 7 months after the workshop. Two trained, blinded, independent observers scored the videotaped encounters.
All 27 interns rotating at the Children's Hospital consented to participate in the study, and 20 attended the workshop. We included all participant data in the analysis, regardless of workshop attendance. Following the intervention, intern reporting of patient acuity improved from 13% to 92% (P < .001), and gains were maintained 7 months later. Rates of key communication behaviors, such as paraphrasing critical information, did not improve.
A brief educational workshop promoting standardized handovers improved the inclusion of essential information during intern handovers, and these improvements were sustained over time. The intervention did not improve key communication behaviors.
毕业后医学教育认证委员会要求住院医师培训项目确保患者交接安全，并记录住院医师在交接沟通方面的能力，但几乎没有基于证据的课程来教授住院医师交接技能。
我们评估了一项简短教育干预对儿科实习医生交接技能的即时和持续影响。
一家独立儿童医院的实习医生参与了一项干预措施，其中包括一个关于高质量交接组成部分的1小时教育研讨会，以及实施标准化交接格式。该格式为SAFETIPS，包括患者信息、当前诊断和评估、患者 acuity、重点计划、基线检查、待办事项清单、预期指导以及潜在的要点和陷阱。还讨论了重要的沟通行为，如对关键信息进行释义。在研讨会前2周、后2周和7个月后，通过模拟会诊评估实习医生交接的质量。两名经过培训、不知情的独立观察员对录像会诊进行评分。
在儿童医院轮转的所有27名实习医生均同意参与研究，20人参加了研讨会。我们将所有参与者的数据纳入分析，无论是否参加研讨会。干预后，实习医生对患者 acuity的报告从13%提高到92%（P <.001），且7个月后仍保持增长。关键沟通行为的发生率，如对关键信息进行释义，并未改善。
一个促进标准化交接的简短教育研讨会提高了实习医生交接过程中基本信息的包含率，且这些改进随着时间的推移得以保持。该干预并未改善关键沟通行为。
