Are attendings different?. Intensivists explain their handoff ideals, perceptions, and practices.

Area of Science:

• Medical communication
• Intensive care medicine
• Physician education

Background:

• Physician handoffs are critical for patient care continuity.
• Existing research on handoffs primarily focuses on resident physicians.
• Attending physicians play a key role in determining care plans and goals.

Purpose of the Study:

• To explore unique aspects of attending intensivist handoffs.
• To identify ideal content and format for intensive care unit (ICU) attending handoffs.
• To assess alignment between ideal and reported attending intensivist handoff practices.

Main Methods:

• Purposive sampling of intensivists in U.S. adult academic ICUs.
• Interviews conducted over 9 months (2011-2012).
• Analysis of data from 30 attending physicians across 15 institutions.

Main Results:

• The ideal attending handoff is succinct, in-person, and combines verbal and written communication.
• Attending handoffs were perceived as needing less detail than resident handoffs.
• Reported practices varied significantly in media (phone, in-person, email, text) and duration; standardized practice was rare.

Conclusions:

• Academic intensivists share common ideals for attending handoffs.
• Significant variation exists in reported attending intensivist handoff practices.
• Ideal handoff attributes can guide future interventions to enhance intensivist communication.