Handoffs and Transitions of CareDepartment of Pathology and Laboratory Medicine

Deborah A. Sesok-Pizzini, M.D., M.B.A.Carolyn Cambor, M.D.

The Goal

Safe and Effective Sign-out

Objectives

Describe Development and Standardization of Policies for Handoffs and Transitions

Define Transitions of CareDefine Resident Schedule for coverageDefine Level of Responsibility and

Expectations for Handoffs

Residency Program Policies for Handoffs and TransitionsClinical PathologyAutopsy PathologySurgical PathologyCytopathology

Document Control

Hospital of the University of PennsylvaniaDepartment of Pathology and Laboratory MedicineDivision of Laboratory MedicineSection: Residency Program Policies Handoffs and Transitions

Version: 1

Effective date: 8/24/2012

Title: Clinical Pathology on Call and Transitions of Care

Clinical Pathology Handoffs

Schedule and Coverage

Define hours per shift coverage (within ACGME guidelines)

Define start and stop time of coverageDefine responsibility of coverage (PGY1-

PGY4)Define responsibility of handoffs

– Who contacts who, how, and where– Required handoffs

Resident Coverage-Transitions of Care

Define Time of transfer of careClinical Pathology

– 5 PM and 9:30 PM– 5 PM daytime resident will contact the PGY1

call resident only if patient care issues need to be handed off

– Care complete when resident verbally or electronically acknowledges the information

Resident Coverage Transition of Care

– 9:30 PM upper level residents contacts the PGY1 to receive information about ongoing patient issues.

– Care complete when resident verbally or electronically acknowledges the information

– Why support 2 different handoffs? Creates learning opportunities for PGY1 residents Allows opportunities for teaching and mentoring

from more senior residents and continuity of overnight coverage

Additional Handoff Mechanisms

Calls during the day are posted as documents on the secure Pathology Pulse webpage

Calls during the evening are also posted Call summaries are faxed to the attending on the

CP service for their review and follow-up the next day

Morning Report Conference for one hour every Mon and Fri, handoffs to residents covering services

Assessment of Handoffs

Plan to perform assessment using the HUP assessment tool available at http://uphsnet-test.uphs.upenn.edu/ResidentPortfolio/Home/Login  

Senior residents and attendings involved in the assessment process

Gave feedback about the need for a N/A selection

“The single biggest problem in communication is the illusion that it has taken place.”

 George Bernard Shaw quotes