1. Jose L. Pascual, MD, PhD FACS, FRCS(C) Division of Trauma, Critical Care & Emergent Surgery May 2013 Handoff Safety Curriculum Department of Surgery - UPHS

2. DOS Intern Signout Curriculum Design Verbal handoff curriculum design 2010  P Jenkins, C Reinke, M Gupta Joined with UPHS initiative 2011  Housestaff Quality and Safety Leadership Council Developed Written Signout Guidelines Compulsory curriculum to Interns in June 2012 Ongoing peer evaluations of giving signout – 2012- 2013

3. Bringing it closer to home… ED Resident Nightfloat surgery consult resident Surgical service Intern On Call Service Intern/AP #1 Surgical service Intern On Call service Intern/AP #2 Day 1 Day 2 Day 3 Day 4 Day 5 6 providers, 7 Handoffs in 5 days Surgical service Intern On Call service Intern/AP #3

6. June 2012  2 hour curriculum  Incoming Interns department of Surgery  Case Based Schedule 10 min – pretest 30 min – powerpoint – importance of oral signouts JCAHO, ‘to err is human etc.. 30 min - bad video, good video, interactive and interrupted by audience comments 20 min - SHOUT + short discussion about written signout 5 min – distribution of references, badges 10 min – post test/survey

7. Goals for Today Get you ready to perform safe handoffs during residency! Review the increasing importance of handoffs Teach the components of good verbal/written handoff Watch and critique videos of handoffs Prepare you to streamline your handoff abilities in front of your senior peers

8. Division: | Freq. Percent Cum. ---------------+-----------------------------------. | 2 4.88 4.88 Card | 1 2.44 7.32 ENT | 4 9.76 17.07 GenSurg | 7 17.07 34.15 IR | 2 4.88 39.02 NSG | 3 7.32 46.34 OMFS | 3 7.32 53.66 Ortho | 5 12.20 65.85 Plastic | 2 4.88 70.73 PrelimSurg | 9 21.95 92.68 Uro | 3 7.32 100.00 ---------------+----------------------------------- Total | 41 100.00 Total Exam Results: Total PreTest Exam: Total Test Subjects: 39 Median: 18 (85.71%) Mean: 16.36 (77.90%) SD: 3.97 Total PostTest Exam: Total Test Subjects: 41 (100%) Median: 20 (95.24%) Mean: 19.37 (92.24%) SD: 1.93

11. Ongoing Evaluations  All interns are being observed and evaluated by a senior housestaff member at least twice during first few months of training.  Evaluations will be entered into New-Innovations  Any senior resident/fellow can be evaluator