Improving residents' handovers through just-in-time training for structured communication

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Quality Improvement

Background:

• Inadequate physician handovers negatively impact patient care and increase resident anxiety.
• Existing literature highlights a strong correlation between handover quality and patient outcomes.

Purpose of the Study:

• To enhance the quality and consistency of in-hospital patient handovers among internal medicine residents.
• To evaluate the impact of a structured handover protocol on handover effectiveness.

Main Methods:

• A quality assurance project involving senior internal medicine residents over three months.
• Residents evaluated handovers using a 16-aspect observational protocol.
• Introduction and refinement of a structured handover procedure (Situation, Background, દવા, Recommendation, Readback - SBARR).

Main Results:

• Initial handovers showed a median of 8/16 practices, with significant variability.
• After introducing SBARR, the median quality increased to 11/16, with reduced variability.
• Sustained improvements were observed after refining the SBARR orientation based on identified errors.

Conclusions:

• A structured handover procedure (SBARR) effectively improves the quality and consistency of in-hospital physician handovers.
• This intervention requires minimal resources and has a favorable impact on patient care and resident confidence.
• Continuous refinement of structured protocols can further optimize healthcare transitions.