A qualitative study of sign-out processes between primary and on-call residents: Relationships in information exchange, responsibility and accountability

Soo Hoon Lee, Dale A. Fisher, Heidi Mah, Wei Ping Goh, Phillip Phan

Research output: Contribution to journalArticle

Abstract

Objective: To review a quality improvement event on the process of sign-outs between the primary and on-call residents. Design: A retrospective qualitative study using semi-structured interviews. Setting: A tertiary academic medical center in Singapore with 283 inpatient Medicine beds served by 28 consultants, 29 registrars, 45 residents and 30 interns during the day but 5 residents and 3 interns at night. Participants: Residents, registrars and consultants. Intervention: Quality improvement event on sign-out. Main outcome: Effectiveness of sign-out comprises exchange of patient information, professional responsibility and task accountability. Results: The following process of sign-outs was noted. Primary teams were accountable to the oncall resident by selecting at-risk patients and preparing contingency plans for sign-out. Structured information exchanged included patient history, active problems and plans of care. On-call residents took ownership of at-risk patients by actively asking questions during sign-out and reporting back the agreed care plan. On-call residents were accountable to the primary team by reporting back at-risk patients the next day. Conclusion: A structured information exchange at sign-out increased the on-call resident's ability to care for at-risk patients when it was supported by two-way transfers of responsibility and accountability.

Original languageEnglish (US)
Pages (from-to)646-653
Number of pages8
JournalInternational Journal for Quality in Health Care
Volume29
Issue number5
DOIs
StatePublished - Oct 1 2017

Fingerprint

Social Responsibility
Consultants
Quality Improvement
Aptitude
Ownership
Singapore
Inpatients
Retrospective Studies
Medicine
Interviews

Keywords

  • Professional responsibility
  • Qualitative methods
  • Resident communication
  • Sign-out
  • Task accountability

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

A qualitative study of sign-out processes between primary and on-call residents : Relationships in information exchange, responsibility and accountability. / Lee, Soo Hoon; Fisher, Dale A.; Mah, Heidi; Goh, Wei Ping; Phan, Phillip.

In: International Journal for Quality in Health Care, Vol. 29, No. 5, 01.10.2017, p. 646-653.

Research output: Contribution to journalArticle

@article{038fa81f2b57493b8bc7de829373b47e,
title = "A qualitative study of sign-out processes between primary and on-call residents: Relationships in information exchange, responsibility and accountability",
abstract = "Objective: To review a quality improvement event on the process of sign-outs between the primary and on-call residents. Design: A retrospective qualitative study using semi-structured interviews. Setting: A tertiary academic medical center in Singapore with 283 inpatient Medicine beds served by 28 consultants, 29 registrars, 45 residents and 30 interns during the day but 5 residents and 3 interns at night. Participants: Residents, registrars and consultants. Intervention: Quality improvement event on sign-out. Main outcome: Effectiveness of sign-out comprises exchange of patient information, professional responsibility and task accountability. Results: The following process of sign-outs was noted. Primary teams were accountable to the oncall resident by selecting at-risk patients and preparing contingency plans for sign-out. Structured information exchanged included patient history, active problems and plans of care. On-call residents took ownership of at-risk patients by actively asking questions during sign-out and reporting back the agreed care plan. On-call residents were accountable to the primary team by reporting back at-risk patients the next day. Conclusion: A structured information exchange at sign-out increased the on-call resident's ability to care for at-risk patients when it was supported by two-way transfers of responsibility and accountability.",
keywords = "Professional responsibility, Qualitative methods, Resident communication, Sign-out, Task accountability",
author = "Lee, {Soo Hoon} and Fisher, {Dale A.} and Heidi Mah and Goh, {Wei Ping} and Phillip Phan",
year = "2017",
month = "10",
day = "1",
doi = "10.1093/intqhc/mzx082",
language = "English (US)",
volume = "29",
pages = "646--653",
journal = "International Journal for Quality in Health Care",
issn = "1353-4505",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - A qualitative study of sign-out processes between primary and on-call residents

T2 - Relationships in information exchange, responsibility and accountability

AU - Lee, Soo Hoon

AU - Fisher, Dale A.

AU - Mah, Heidi

AU - Goh, Wei Ping

AU - Phan, Phillip

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Objective: To review a quality improvement event on the process of sign-outs between the primary and on-call residents. Design: A retrospective qualitative study using semi-structured interviews. Setting: A tertiary academic medical center in Singapore with 283 inpatient Medicine beds served by 28 consultants, 29 registrars, 45 residents and 30 interns during the day but 5 residents and 3 interns at night. Participants: Residents, registrars and consultants. Intervention: Quality improvement event on sign-out. Main outcome: Effectiveness of sign-out comprises exchange of patient information, professional responsibility and task accountability. Results: The following process of sign-outs was noted. Primary teams were accountable to the oncall resident by selecting at-risk patients and preparing contingency plans for sign-out. Structured information exchanged included patient history, active problems and plans of care. On-call residents took ownership of at-risk patients by actively asking questions during sign-out and reporting back the agreed care plan. On-call residents were accountable to the primary team by reporting back at-risk patients the next day. Conclusion: A structured information exchange at sign-out increased the on-call resident's ability to care for at-risk patients when it was supported by two-way transfers of responsibility and accountability.

AB - Objective: To review a quality improvement event on the process of sign-outs between the primary and on-call residents. Design: A retrospective qualitative study using semi-structured interviews. Setting: A tertiary academic medical center in Singapore with 283 inpatient Medicine beds served by 28 consultants, 29 registrars, 45 residents and 30 interns during the day but 5 residents and 3 interns at night. Participants: Residents, registrars and consultants. Intervention: Quality improvement event on sign-out. Main outcome: Effectiveness of sign-out comprises exchange of patient information, professional responsibility and task accountability. Results: The following process of sign-outs was noted. Primary teams were accountable to the oncall resident by selecting at-risk patients and preparing contingency plans for sign-out. Structured information exchanged included patient history, active problems and plans of care. On-call residents took ownership of at-risk patients by actively asking questions during sign-out and reporting back the agreed care plan. On-call residents were accountable to the primary team by reporting back at-risk patients the next day. Conclusion: A structured information exchange at sign-out increased the on-call resident's ability to care for at-risk patients when it was supported by two-way transfers of responsibility and accountability.

KW - Professional responsibility

KW - Qualitative methods

KW - Resident communication

KW - Sign-out

KW - Task accountability

UR - http://www.scopus.com/inward/record.url?scp=85031759090&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85031759090&partnerID=8YFLogxK

U2 - 10.1093/intqhc/mzx082

DO - 10.1093/intqhc/mzx082

M3 - Article

C2 - 28992143

AN - SCOPUS:85031759090

VL - 29

SP - 646

EP - 653

JO - International Journal for Quality in Health Care

JF - International Journal for Quality in Health Care

SN - 1353-4505

IS - 5

ER -