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A Handoffs Software Led to Fewer Errors of Omission and Better Provider Satisfaction: A Randomized Control Trial

Kashiouris, Markos G. MD, MPH*; Stefanou, Christos MD; Sharma, Deepankar MD*; Yshii-Tamashiro, Cecilia MD; Vega, Ryan MD§; Hartingan, Sarah MD§; Albrecht, Charles III MD; Brown, Robert H. MD, MPH

doi: 10.1097/PTS.0000000000000340
Original Article: PDF Only

Background Computer-assisted communication is shown to prevent critical omissions (“errors”) in the handoff process.

Objective The aim of the study was to study this effect and related provider satisfaction, using a standardized software.

Methods Fourteen internal medicine house officers staffed 6 days and 1 cross-covering teams were randomized to either the intervention group or control, employing usual handoff, so that handoff information was exchanged only between same-group subjects (daily, for 28 days).

Results In the intervention group, fewer omissions (among those studied) occurred intravenous access (17 versus 422, P < 0.001), code status (1 versus 158, P < 0.001), diet/nothing per mouth (28 versus 477, P < 0.001), and deep venous thrombosis prophylaxis (17 versus 284, P < 0.001); duration to compose handoff was similar; and physicians perceived less workload adjusted for patient census and provider characteristics (P = 0.004) as well as better handoff quality (P < 0.001) and clarity (P < 0.001).

Conclusions The intervention was associated with fewer errors and superior provider satisfaction.

From the *Division of Pulmonary and Critical Care Medicine, Virginia Commonwealth University, Richmond, Virginia; †Division of Pulmonary and Critical Care Medicine, National and Kapodistrian University of Athens, Athens Greece; ‡Division of Pulmonary and Critical Care Medicine, University of Tennessee, Knoxville, Tennessee; §Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia; ∥Chief Quality Officer, Department of Internal Medicine, Sinai Hospital of Baltimore; and ¶Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Correspondence: Markos G. Kashiouris, MD, MPH, Division of Pulmonary and Critical Care Medicine, Virginia Commonwealth University, 1200 E. Broad Street, Box 980050, Richmond, VA 23298-0050 (e-mail:

The authors disclose no conflict of interest.

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