+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The Impact of a Standardized Checklist on Transition of Care During Emergency Department Resident Physician Change of Shift

The Impact of a Standardized Checklist on Transition of Care During Emergency Department Resident Physician Change of Shift

Western Journal of Emergency Medicine 20(1): 29-34

Transitions of patient care during physicians' change of shift introduce the potential for critical information to be missed or distorted, resulting in possible morbidity. The Joint Commission, the Accreditation Council for Graduate Medical Education, and the Society of Hospital Medicine jointly encourage a structured format for patient care sign-out. This study's objective was to examine the impact of a standardized checklist on the quality of emergency medicine (EM) resident physicians' patient-care transition at shift change. Investigators developed a standardized sign-out checklist for EM residents to complete prior to sign out. This checklist included topics of diagnoses, patient-care tasks to do, patient disposition, admission team, and patient code status. Two EM attending physicians, the incoming and departing, assessed the quality of transitions of care at this shift change using a standardized assessment form. This form also assessed overall quality of sign-out using a visual analog scale (VAS), based on a 10-centimeter scale. For two months, we collected initial, status quo data (pre-checklist [PCL] cohort) followed by two months of residents using the checklist (post-checklist [CL] cohort). We collected data for 77 days (July 1, 2015 - November 11, 2015), 38 days of status quo sign-out followed by 39 days of checklist utilization, comprised of 1,245 attending assessments. Global assessment of sign-out for the CL was 8 compared to 7.5 for the PCL. Aspects of transition of care that implementation of the sign-out checklist impacted included the following (reported as a frequency): "To Do" (PCL 84.3%, CL 97.8%); "Disposition" (PCL 97.2%, CL 99.4%); "Admit Team" (67.1%, CL 76.2%); and "Attending Add" (PCL 23.4%, CL 11.3%). Implementation of a sign-out checklist enhanced EM resident physician transition of care at shift end by increasing the frequency of discussion of critical tasks remaining for patient care, disposition status, and subjective assessment of quality of sign-out.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 066089992

Download citation: RISBibTeXText

PMID: 30643598

DOI: 10.5811/westjem.2018.10.39020

Related references

Change of shift. A Note to Self: From an Emergency Department Boarder to a Future Emergency Physician. Annals of Emergency Medicine 66(2): 199-200, 2015

Implementation of an emergency department sign-out checklist improves transfer of information at shift change. Journal of Emergency Medicine 47(5): 580-585, 2014

The impact of resident physician coverage on emergency department visits in South Carolina. Southern Medical Journal 96(12): 1195-1202, 2003

Relative productivity of nurse practitioner and resident physician care models in the pediatric emergency department. Pediatric Emergency Care 31(2): 101-106, 2016

Change of shift. Colombian orchids: palliative care in the emergency department. Annals of Emergency Medicine 61(4): 488, 2013

Resident productivity as a function of emergency department volume, shift time of day, and cumulative time in the emergency department. American Journal of Emergency Medicine 27(3): 313-319, 2009

Impact of a standardized communication system on continuity of care between family physicians and the emergency department. Cjem 9(2): 79-86, 2007

An attending physician float shift for the improvement of physician productivity in a crowded emergency department. World Journal of Emergency Medicine 4(1): 10-14, 2013

Physician practice variation in the pediatric emergency department and its impact on resource use and quality of care. Pediatric Emergency Care 26(12): 902-908, 2010

Off-service resident education in the emergency department: outline of a national standardized curriculum. Academic Emergency Medicine 16(12): 1325-1330, 2010

The emergency to home project: impact of an emergency department care coordinator on hospital admission and emergency department utilization among seniors. International Journal of Emergency Medicine 7: 18, 2014

The impact of a primary care physician cooperative on the caseload of an emergency department: the Maastricht integrated out-of-hours service. Journal of General Internal Medicine 20(7): 612-617, 2005

Increasing off-service resident productivity while on their emergency department rotation using shift cards. Journal of Emergency Medicine 48(4): 499-505, 2016

Change in Care Transition Practice for Patients With Nonspecific Chest Pain After Emergency Department Evaluation 2006 to 2012. Academic Emergency Medicine 24(12): 1527-1530, 2017

Does the presence of a toxicologist impact emergency medicine resident practices when treating poisoned patients in the emergency department?. Journal of Toxicology Clinical Toxicology 35(5): 484, 1997