Distractions during resident handoffs: incidence, sources, and influence on handoff quality and effectiveness

JAMA Surgery
Cristan E AndersonLygia Stewart

Abstract

Handoffs have significantly increased in number following Accreditation Council for Graduate Medical Education (ACGME) work-hour restrictions. Studies have shown correlations between the number of handoffs and errors/patient harm. Distractions are common during handoffs and may interfere with handoff quality and effectiveness. To examine the frequency of distractions and their impact on handoff quality. In this prospective observational study, a total of 214 surgical resident handoffs (residents = 184; Bay area residents [moonlighters] = 30) were observed over 18 months (July 11, 2012-December 19, 2014) by 2 independent observers in 3 teaching hospitals (university, county, and veterans). Handoff quality (both giver and receiver) was assessed using a standardized scoring system. The number and types of distractions were recorded. Pages were the most common distraction (37.5%), followed by telephone calls (32.8%), residents/medical students (9.3%), talking (5.2%), and noise (4.1%). Distractions from attending physicians, electronics, nursing, consults, and room changes were less common (collectively 11%, each <3%). Distractions were present in 102 resident handoffs (48%) (16% with 1 distraction; 15% with 2; 6% with 3, and 11% wi...Continue Reading

Citations

May 5, 2018·Simulation in Healthcare : Journal of the Society for Simulation in Healthcare·Lukas H MaternVineet M Arora
Apr 21, 2018·The Journal of Trauma and Acute Care Surgery·David P StonkoOscar D Guillamondegui
Oct 13, 2018·Critical Care Medicine·Alexander F Arriaga
Jun 20, 2018·Journal of Nursing Care Quality·Amy J SpoonerLeanne M Aitken
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Jan 22, 2021·BMJ Open Quality·Vilmaris Quinones CardonaSuzanne M Touch
Mar 2, 2021·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Vashisht PersadHoward Minkoff
Apr 30, 2017·Journal of Patient Safety·Ephrem AbebeMichelle A Chui

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