Transfer Protocols

1). Effective transfers of patient care are dependent upon the ability of both parties to give and receive information to optimize patient safety.

2). Transitions of care must be kept to a minimum to avoid interruptions in patient care

3). An adequate sign-out is essential for every transition of care for every patient

4). The sign out should satisfy the guidelines outlined by PSNet (Patient safety network) of Agency for Healthcare Research and Quality (AHRQ). The components of a safe and effective sign out should include the acronym: ANTICipate:

A-Administrative data (eg, patients name, medical record number and location) must be accurate

N- New clinical information must be updated

T- Tasks to be performed by the covering provider must be clearly explained

I- Illness severity must be communicated

C- Contingency plans for changes in clinical status

5). The sign out has to include all components of care involving all patients whose care is in transition. This includes, demographic information, admission details, diagnoses, diagnostic work up and procedures undertaken till now, post-operative course, current treatment plan, likely changes in condition and care for the next period of care, pending investigations or treatments that need to followed up and the details of the responsible Senior Resident and Attending.

6). The sign out must be performed in person by face-to-face meeting. 

7). The sign out must be performed between resident to resident. On services that include mid-level providers that sign out must be performed face-to- face between the provider and residents.

8). The sign out should include a list (or census) of patients with their location details. If needed, the list can include brief information of pertinent history and other clinical details. Sign outs can be performed on paper or on a computerized system (EPIC)

9). The sign outs must be performed in the presence of an attending physician (some services) or senior residents. 

Further sample educational materials  can be obtained from the following websites:

http://www.psnet.ahrq.gov/primer.aspx?primerID=9

https://www.mededportal.org/publication/8331

 

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