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Need for Standardized Sign‐out in the Emergency Department: A Survey of Emergency Medicine Residency and Pediatric Emergency Medicine Fellowship Program Directors
Author(s) -
Sinha Madhumita,
Shriki Jesse,
Salness Rebecca,
Blackburn Paul A.
Publication year - 2007
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1197/j.aem.2006.09.048
Subject(s) - accreditation , medicine , pediatric emergency medicine , graduate medical education , emergency department , sign (mathematics) , family medicine , program director , residency training , emergency medicine , medical emergency , medical education , nursing , emergency physician , continuing education , mathematical analysis , mathematics
Objectives To determine the existing patterns of sign‐out processes prevalent in emergency departments (EDs) nationwide. In addition, to assess whether training programs provide specific guidance to their trainees regarding sign‐outs and attitudes of emergency medicine (EM) residency and pediatric EM fellowship program directors toward the need for the development of standardized guidelines relating to sign‐outs. Methods A Web‐based survey of training program directors of each Accreditation Council for Graduate Medical Education (ACGME)–accredited EM residency and pediatric EM fellowship program was conducted in March 2006. Results Overall, 185 (61.1%) program directors responded to the survey. One hundred thirty‐six (73.5%) program directors reported that sign‐outs at change of shift occurred in a common area within the ED, and 79 (42.7%) respondents indicated combined sign‐outs in the presence of both attending and resident physicians. A majority of the programs, 119 (89.5%), stated that there was no uniform written policy regarding patient sign‐out in their ED. Half (50.3%) of all those surveyed reported that physicians sign out patient details “verbally only,” and 79 (42.9%) noted that transfer of attending responsibility was “rarely documented.” Only 34 (25.6%) programs affirmed that they had formal didactic sessions focused on sign‐outs. A majority (71.6%) of program directors surveyed agreed that specific practice parameters regarding transfer of care in the ED would improve patient care; 80 (72.3%) agreed that a standardized sign‐out system in the ED would improve communication and reduce medical error. Conclusions There is wide variation in the sign‐out processes followed by different EDs. A majority of those surveyed expressed the need for standardized sign‐out systems.