541 - Improvement in Residents’ Efficiency and Satisfaction in their Pediatric ICU Rotation with the Implementation of an EMR-Integrated Handoff Report

Poster Number: 541
Publication Number: 541.324

Caroline Young, University of Tennessee Health Science Center, Memphis, TN, United States; Bindiya Bagga, UTHSC, Memphis, TN, United States; Pilar Anton-Martin, University of Tennessee Health Science Center College of Medicine, Memphis, TN, United States

Background: In the era of resident wellbeing and duty hours, efficient handoff is paramount. While handoff is critical to patient safety, it is also known to be error-prone (1). Prior studies have proposed that a standardized handoff system can reduce medical errors and improve efficiency (2, 3). Before July 2022, handoff in our PICU was done verbally using the aid of a census list. To improve provider efficiency and satisfaction, an EMR-integrated handoff system including relevant information for the care of critically ill children was implemented.

Objective: We aimed to evaluate the need for a new EMR-integrated handoff system in our PICU and to compare physician-perceived efficiency and satisfaction using this handoff compared to the prior verbal system.

Design/Methods: Resident physicians who had previously utilized verbal handoff in the PICU completed a survey to evaluate their perceptions of it and assess the needs for an improved system. Residents were trained on the use of this new handoff at the start of their PICU rotation, and it was launched and incorporated into our institution’s EMR in July 2022. All residents completing PICU rotations July through December 2022 were surveyed on their perceptions of the EMR-integrated handoff system.

Results: Of the 62 residents who completed the pre-survey, < 50% were satisfied with the verbal handoff system. They felt that a new EMR-integrated handoff would improve speed and efficiency of reviewing patients prior to their shift (77%), of signing out to another provider (87%), and their preparedness for rounds (75%). Over the six months post-implementation, 27 residents completed a post-survey, with 92% satisfied using the new handoff report. Use of the new handoff led to a reduction in residents’ perceived unpreparedness for rounds (75% vs 54%, p 0.001) and need to double-check information due to signout inaccuracies (81% vs 66%, p 0.01). There was an increased rate of residents reporting < 30 minutes each for pre-rounding (32% vs 69%, p < 0.001) and sign-out to another provider (72% vs 96%, p < 0.001). Additionally, the rate of residents perceiving they miss essential information in handoffs was reduced (82% vs 76%), but this was not significant (p 0.29).

Conclusion(s): This EMR-integrated handoff has been an added benefit to resident physicians in our PICU, both improving comfortability with signout and efficiency in preparing for rounds and cross-cover. The concept of an EMR-integrated handoff system can likely be generalized for use in many PICUs and serves as a possible solution to the error-prone increased handoffs necessitated by duty hour requirements.