Teaching and Assessing ED Handoffs: A Qualitative Study Exploring Resident, Attending, and Nurse Perceptions
Introduction: The Accreditation Council for Graduate Medical Education requires that residency programs ensure resident competency in performing safe, effective handoffs. Understanding resident, attending, and nurse perceptions of the key elements of a safe and effective emergency department (ED)...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2015-10-01
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| Series: | Western Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://escholarship.org/uc/item/91b1p5fc |
| _version_ | 1818997258117447680 |
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| author | Moira Flanigan James A. Heilman Tom Johnson Lalena M. Yarris |
| author_facet | Moira Flanigan James A. Heilman Tom Johnson Lalena M. Yarris |
| author_sort | Moira Flanigan |
| collection | DOAJ |
| description | Introduction: The Accreditation Council for Graduate Medical Education requires that residency
programs ensure resident competency in performing safe, effective handoffs. Understanding
resident, attending, and nurse perceptions of the key elements of a safe and effective emergency
department (ED) handoff is a crucial step to developing feasible, acceptable educational
interventions to teach and assess this fundamental competency. The aim of our study was to identify
the essential themes of ED-based handoffs and to explore the key cultural and interprofessional
themes that may be barriers to developing and implementing successful ED-based educational
handoff interventions.
Methods: Using a grounded theory approach and constructivist/interpretivist research paradigm, we
analyzed data from three primary and one confirmatory focus groups (FGs) at an urban, academic
ED. FG protocols were developed using open-ended questions that sought to understand what
participants felt were the crucial elements of ED handoffs. ED residents, attendings, a physician
assistant, and nurses participated in the FGs. FGs were observed, hand-transcribed, audiorecorded
and subsequently transcribed. We analyzed data using an iterative process of theme and
subtheme identification. Saturation was reached during the third FG, and the fourth confirmatory
group reinforced the identified themes. Two team members analyzed the transcripts separately and
identified the same major themes.
Results: ED providers identified that crucial elements of ED handoff include the following: 1) Culture
(provider buy-in, openness to change, shared expectations of sign-out goals); 2) Time (brevity,
interruptions, waiting); 3) Environment (physical location, ED factors); 4) Process (standardization,
information order, tools).
Conclusion: Key participants in the ED handoff process perceive that the crucial elements of
intershift handoffs involve the themes of culture, time, environment, and process. Attention to these
themes may improve the feasibility and acceptance of educational interventions that aim to teach
and assess handoff competency. |
| first_indexed | 2024-12-20T21:42:46Z |
| format | Article |
| id | doaj.art-c315cf515903499eacc5ca1ab1dfcff5 |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-12-20T21:42:46Z |
| publishDate | 2015-10-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-c315cf515903499eacc5ca1ab1dfcff52022-12-21T19:25:45ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182015-10-0116682382910.5811/westjem.2015.8.27278Teaching and Assessing ED Handoffs: A Qualitative Study Exploring Resident, Attending, and Nurse PerceptionsMoira Flanigan0James A. Heilman1Tom Johnson2Lalena M. Yarris3Oregon Health and Science University, Department of Emergency Medicine, Portland, OregonOregon Health and Science University, Department of Emergency Medicine, Portland, OregonOregon Health and Science University, Department of Emergency Medicine, Portland, OregonOregon Health and Science University, Department of Emergency Medicine, Portland, OregonIntroduction: The Accreditation Council for Graduate Medical Education requires that residency programs ensure resident competency in performing safe, effective handoffs. Understanding resident, attending, and nurse perceptions of the key elements of a safe and effective emergency department (ED) handoff is a crucial step to developing feasible, acceptable educational interventions to teach and assess this fundamental competency. The aim of our study was to identify the essential themes of ED-based handoffs and to explore the key cultural and interprofessional themes that may be barriers to developing and implementing successful ED-based educational handoff interventions. Methods: Using a grounded theory approach and constructivist/interpretivist research paradigm, we analyzed data from three primary and one confirmatory focus groups (FGs) at an urban, academic ED. FG protocols were developed using open-ended questions that sought to understand what participants felt were the crucial elements of ED handoffs. ED residents, attendings, a physician assistant, and nurses participated in the FGs. FGs were observed, hand-transcribed, audiorecorded and subsequently transcribed. We analyzed data using an iterative process of theme and subtheme identification. Saturation was reached during the third FG, and the fourth confirmatory group reinforced the identified themes. Two team members analyzed the transcripts separately and identified the same major themes. Results: ED providers identified that crucial elements of ED handoff include the following: 1) Culture (provider buy-in, openness to change, shared expectations of sign-out goals); 2) Time (brevity, interruptions, waiting); 3) Environment (physical location, ED factors); 4) Process (standardization, information order, tools). Conclusion: Key participants in the ED handoff process perceive that the crucial elements of intershift handoffs involve the themes of culture, time, environment, and process. Attention to these themes may improve the feasibility and acceptance of educational interventions that aim to teach and assess handoff competency.http://escholarship.org/uc/item/91b1p5fcEmergency MedicineHandoffsTransitions in CareResident Education |
| spellingShingle | Moira Flanigan James A. Heilman Tom Johnson Lalena M. Yarris Teaching and Assessing ED Handoffs: A Qualitative Study Exploring Resident, Attending, and Nurse Perceptions Western Journal of Emergency Medicine Emergency Medicine Handoffs Transitions in Care Resident Education |
| title | Teaching and Assessing ED Handoffs: A Qualitative Study Exploring Resident, Attending, and Nurse Perceptions |
| title_full | Teaching and Assessing ED Handoffs: A Qualitative Study Exploring Resident, Attending, and Nurse Perceptions |
| title_fullStr | Teaching and Assessing ED Handoffs: A Qualitative Study Exploring Resident, Attending, and Nurse Perceptions |
| title_full_unstemmed | Teaching and Assessing ED Handoffs: A Qualitative Study Exploring Resident, Attending, and Nurse Perceptions |
| title_short | Teaching and Assessing ED Handoffs: A Qualitative Study Exploring Resident, Attending, and Nurse Perceptions |
| title_sort | teaching and assessing ed handoffs a qualitative study exploring resident attending and nurse perceptions |
| topic | Emergency Medicine Handoffs Transitions in Care Resident Education |
| url | http://escholarship.org/uc/item/91b1p5fc |
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