Implementation of a standard verbal sign-out template improves sign-out process in a pediatric intensive care unit

Aarti C. Bavare, Pankil K. Shah, Kevin M. Roy, Eric A. Williams, Linda E. Lloyd, Mona L. McPherson

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Sign-out of patient data at change of shifts is vulnerable to errors that impact patient safety. Although sign-outs are complex in intensive care units (ICU), a paucity of studies exists evaluating optimal ICU sign-out. Our prospective interventional study investigated the use of a standard verbal template in a Pediatric ICU to improve the sign-out process. We designed and validated a survey tool to measure 10 items of optimal sign-out. The survey and analysis of sign-out information exchanged was performed pre- and postintervention. Forty-eight clinicians participated, with a survey response rate of 88% and 81% in the pre- and postintervention phases, respectively. Seventy-nine percent clinicians identified the need for sign-out improvement. Clinician satisfaction with sign-out increased postintervention (preintervention survey scores: 3.26 (CI: 3.09-3.43), postintervention 3.9 (CI: 3.76-4.04) [p <.01]). Three scorers analyzed the verbal and written sign-out content with good inter-rater reliability. After the intervention, sign-out content revealed increased patient identification, background description, account of system-based clinical details [p =.001] and notation of clinical details, code status, and goals [p <.002]. Interruptions decreased [p =.04] without any change in sign-out duration [p =.86]. The standard verbal template improved clinician satisfaction with sign-out, augmented the amount of information transferred and decreased interruptions without increasing the duration of sign-out.

Original languageEnglish (US)
Pages (from-to)267-276
Number of pages10
JournalJournal for Healthcare Quality
Volume37
Issue number5
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

Keywords

  • Handover
  • Pediatric intensive care
  • Sign-out
  • Verbal handoff and communication

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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