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. 2018 Jan;33(1):116-119.
doi: 10.1007/s11606-017-4145-4. Epub 2017 Aug 14.

Warm Handoffs: a Novel Strategy to Improve End-of-Rotation Care Transitions

Harry S Saag  1 , Jingjing Chen  2 , Joshua L Denson  3 , Simon Jones  4 , Leora Horwitz  5   4 , Patrick M Cocks  5
Affiliations

Warm Handoffs: a Novel Strategy to Improve End-of-Rotation Care Transitions

Harry S Saag et al. J Gen Intern Med. 2018 Jan.

Abstract

Background: Hospitalized medical patients undergoing transition of care by house staff teams at the end of a ward rotation are associated with an increased risk of mortality, yet best practices surrounding this transition are lacking.

Aim: To assess the impact of a warm handoff protocol for end-of-rotation care transitions.

Setting: A large, university-based internal medicine residency using three different training sites.

Participants: PGY-2 and PGY-3 internal medicine residents.

Program description: Implementation of a warm handoff protocol whereby the incoming and outgoing residents meet at the hospital to sign out in-person and jointly round at the bedside on sicker patients using a checklist.

Program evaluation: An eight-question survey completed by 60 of 99 eligible residents demonstrated that 85% of residents perceived warm handoffs to be safer for patients (p < 0.001), while 98% felt warm handoffs improved their knowledge and comfort level of patients on day 1 of an inpatient rotation (p < 0.001) as compared to prior handoff techniques. Finally, 88% felt warm handoffs were worthwhile despite requiring additional time (p < 0.001).

Discussion: A warm handoff protocol represents a novel strategy to potentially mitigate the known risks associated with end-of-rotation care transitions. Additional studies analyzing patient outcomes will be needed to assess the impact of this strategy.

Keywords: care transitions; medical education-graduate; patient safety.

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Conflict of interest statement

The authors declare no conflicts of interest.

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