• Christopher Nabors, Dhruv Patel, Sahil Khera, Dhaval Kolte, Ridhi Gupta, Nivas Balasubramaniyam, Samir Ambrale, Nikhil Mukhi, Rajat Lamba, Vidya Ramachandraiah, Kathir Subramanian, Rashid Syed, Kyung Hun Nam, Inderpreet Kaur Dardi, Shoma Bommena, Varun Mittal, and Stephen J Peterson.
• From the Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, New York.
• J Patient Saf. 2015 Mar 1;11(1):36-41.

ObjectivesThe clinician arriving at the hospital in the morning may not yet be aware of key overnight clinical activity. To address this situation at our facility, we modified our handoff software to permit continuous updating of clinical information and the automatic relay of important overnight clinical updates to relevant providers each morning.MethodsCross-covering residents electronically entered safety concerns and clinical issues within the reporting module of the handoff software between 5 PM and 7 AM. This updated their handoff-information at shift change and permitted the generation of reports that were emailed to primary providers and reviewed before 7 AM prerounds. At 7:30 sign-out, if a resident was already aware of an issue being signed out, he/she indicated this so that sign-out could quickly proceed to the next patient. Study sign-out duration was recorded, and residents were surveyed regarding the new communication system.ResultsMorning sign-out duration decreased from 25.5 to 22.7 minutes (P = 0.0338). All respondents agreed strongly (12/14, 86%) or somewhat (2/14, 14%) that daily morning events reports prevented "loss of key information between shifts" and enhanced safety greatly (10/14, 71%) or moderately (4/14, 29%).All agreed either strongly (10/14, 71%) or somewhat (4/14, 29%) that the daily report improved the quality of handoff information and strongly (12/14, 86%) or somewhat (2/14, 14%) that the report was convenient.ConclusionsThe collection of key clinical handoff information and its automatic forwarding to incoming providers reduced the average duration of resident morning sign-out and significantly enhanced provider perceptions regarding patient safety and the quality of handoff information.

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