Structured resident sign-out during shift changes improves patient care


In this video, Dr. Brian Moseley discusses a study of a new structured sign out system for resident shift changes. The study was presented at the American Academy of Neurology annual meeting in New Orleans.

In the study, junior residents in Mayo Clinic’s General Neurology, Stroke and Neurologic Intensive Care Units spent the first half of their rotations using unstructured sign-out approaches and transitioned to a structured system for the second half. The residents reported that the standardized sign-out improved communication substantially, including information on pertinent past medical history, pending lab tests, recommendations on how to handle nursing and pharmacy calls, and up-to-date code status. Residents using standardized sign-out were also more likely to share test results with patients and their families prior to shift changes. This led to a significant increase in overall satisfaction with the sign-out process.

“This study is particularly timely now, when residency programs are adjusting to new duty-hour restrictions established in 2010,” says lead author Brian Moseley, M.D., a Mayo Clinic neurology resident and Assistant Professor of Neurology. “When you have hand-offs because of the duty restrictions, unless the communication is good, there is a lot of opportunity for error,” says Jeffrey Britton, M.D., a Mayo Clinic neurologist and study co-author. “This structured method seems to both prevent the error, but also make the patient and their family feel comfortable that this important communication is happening,” says Dr. Britton.

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