Evaluation of the University of Utah Emergency Medicine Residency Patient Hand-off Process Katie Wells, MD, MPH, Ian Buchanan, MD, Alison Frizell, MD, Anne Porter, MD, Susan Stroud, MD, Troy Madsen, MD, Robert Stephen, MD, Margaret Carlson, BS, Jacob Steenblik, MPH, MHA, Megan Fix, MD Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City, Utah

Background Objectives Evaluation of the University of Utah Emergency Medicine Residency Patient Hand-off Process Background Recent studies suggest that structured hand-offs improve patient care and decrease poor patient outcomes in addition to decreasing post-shift length of stay for providers. . Objectives We sought to evaluate the perception of our current informal patient hand-off process prior to developing and implementing a structured hand-off process. .

Methods Evaluation of the University of Utah Emergency Medicine Residency Patient Hand-off Process Methods Needs assessment conducted Hand-off (HO) Committee assembled (PDs, APDs, Attending's (ATT) and Residents (RES) ) Anonymous electronic survey conducted (5-point likert scale survey) Data collected retrospectively utilizing REDCAP software The survey assessed perceptions of giving and receiving hand-offs, interruptions, and effectiveness. Research associate observed and timed RES hand-offs in the ED and total RES interruptions  We sought to evaluate the perception of our current informal patient hand-off process prior to developing and implementing a structured hand-off process

Results Evaluation of the University of Utah Emergency Medicine Residency Patient Hand-off Process Results Response Rate: 100% ATT (n=21), 96% RES (n=27) 90% RES & ATT felt structured HO would be helpful 61% RES & ATT current HO was effective, 22% RES & 0% ATT felt HO was ineffective 77% RES reported failed HO leading to error 73% RES did not review vital sign trends Barriers to HO: ED volume, nurse interruption, mismatched ATT & RES shift times 77% RES stated their HO differed from ATT Interruption rate average 3.84 per HO (min=0, max= 15)

Conclusions Evaluation of the University of Utah Emergency Medicine Residency Patient Hand-off Process Conclusions Most survey participants felt a structured hand-off process would benefit patient care, safety and workflow efficiency in an academic ED. The survey identified improvements for a structured hand-off process including more congruent timing of ATT and RES shifts and formal review of vital sign trends. Evaluation of current practice prior to implementing a formalized hand-off process is necessary to identify areas of improvement.