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Journal article
Reliability of Verbal Handoff Assessment and Handoff Quality Before and After Implementation of a Resident Handoff Bundle
Academic pediatrics, v 16(6), pp 524-531
01 Aug 2016
PMID: 27090858
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
OBJECTIVE: 1) To develop validity evidence for the use of the Verbal Handoff Assessment Tool (VHAT) and examine the reliability of VHAT scores, and 2) to determine whether implementation of a resident handoff bundle (RIM) was associated with improved verbal patient handoffs among pediatric resident physicians.
METHODS: In a pre-post design, prospectively audio recorded verbal patient handoffs conducted at Boston Children's Hospital before and after implementation of the RHB were rated using the VHAT, which was developed for this study (primary outcome). Using generalizability theory, we evaluated the reliability of VHAT scores.
RESULTS: Overall, VHAT scores increased after RHB implementation (mean 142 vs 191, possible score 0-500; P < .0001). When accounting for clustering according to resident physician, hospital unit, unit census, and patient complexity, implementation of the RHB was associated with a 63-point increase in VHAT score. Using generalizability theory, we determined that a resident's mean VHAT score on the basis of a handoff of 15 patients assessed by a single observer was sufficiently reliable for relative ranking decisions (ie, norm-based; generalizability coefficient, 0.81), whereas a VHAT score on the basis of a handoff of 21 patients would be sufficiently reliable for high-stakes, standard-based decisions (Phi, 0.80).
CONCLUSIONS: Verbal handoffs improved after implementation of a RHB, although gains were variable across the 2 clinical units. The VHAT shows promise as an assessment tool for resident handoff skills. If used for competency or entrustment decisions, a resident's mean VHAT score should be on the basis of observation of verbal handoff of patients.
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Details
- Title
- Reliability of Verbal Handoff Assessment and Handoff Quality Before and After Implementation of a Resident Handoff Bundle
- Creators
- Angela M. Feraco - Boston Children's HospitalAmy J. Starmer - Boston Children's HospitalTheodore C. Sectish - Boston Children's HospitalNancy D. Spector - Drexel UniversityDaniel C. West - UCSF Benioff Children's HospitalChristopher P. Landrigan - Brigham and Women's Hospital
- Publication Details
- Academic pediatrics, v 16(6), pp 524-531
- Publisher
- Elsevier
- Number of pages
- 8
- Grant note
- Pfizer Boston Children's Hospital Program for Patient Safety and Quality Research Grant Program 1R18AE000029 / US Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation K12HS019456 / AGENCY FOR HEALTHCARE RESEARCH AND QUALITY; United States Department of Health & Human Services; Agency for Healthcare Research & Quality Controlled Risk Insurance Company Risk Management Foundation Grant Program 1K12HS019456-01 / Oregon Comparative Effectiveness Research K12 Program through the Agency for Healthcare Research and Quality T32HL007574 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Child Health Corporation of America T32 HP10018 / National Research Service Award in Pediatrics 5T32HL007574-33 / National Heart, Lung, and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000381063900006
- Scopus ID
- 2-s2.0-84969921380
- Other Identifier
- 991019335230704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics