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Changes in written sign‐out composition across hospitalization
Author(s) -
Miller Donna M.,
Schapira Marilyn M.,
Visotcky Alexis M.,
Laud Purushottam,
Arora Vineet M.,
Kordus Andrew,
Whittle Jeff,
Singh Siddhartha,
Fletcher Kathlyn E.
Publication year - 2015
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.2390
Subject(s) - medicine , sign (mathematics) , workload , observational study , sign language , hospital medicine , quality (philosophy) , family medicine , computer science , linguistics , mathematical analysis , philosophy , operating system , mathematics , epistemology
BACKGROUND Inaccurate or incomplete information in the written portion of the patient handoff, or sign‐out, may be associated with adverse events in hospitalized patients. Little is known about what information providers actually include in written sign‐out documents and how sign‐outs change over time. OBJECTIVES (1) Provide a descriptive analysis of initial and subsequent hospital day‐written sign‐out content, and (2) evaluate the relationship between team workload and sign‐out composition. DESIGN Retrospective review of sign‐out documents from a larger observational study of general medicine patients admitted to housestaff and hospitalist teams at 3 hospitals. MAIN MEASURES The presence of 13 components of a high‐quality sign‐out. We performed descriptive analyses and compared initial and subsequent day sign‐outs for content. KEY RESULTS We reviewed 200 patient hospitalizations (200 initial handoffs, 580 subsequent day handoffs). Initial sign‐out entries contained a mean of 7.54 (standard deviation: 2.27) key sign‐out components. Subsequent day sign‐outs contained a higher percentage of certain key elements but had more vague language. The number of elements present in the sign‐out was reduced as patient census increased ( r = −0.295, P < 0.01). CONCLUSIONS Sign‐out composition changes over time, and is associated with workload. Future interventions to improve quality should take these factors into consideration. Journal of Hospital Medicine 2015;10:534–536. © 2015 Society of Hospital Medicine.