Development of a handoff evaluation tool for shift-to-shift physician handoffs: The handoff CEX

摘要: BACKGROUND Increasing frequency of shift-to-shift handoffs coupled with regulatory requirements to evaluate handoff quality make a evaluation tool necessary. OBJECTIVE To develop tool. DESIGN Tool development. SETTING Two academic medical centers. SUBJECTS Nurse practitioners, medicine housestaff, and hospitalist attendings. INTERVENTION Concurrent peer external evaluations handoffs. MEASUREMENTS The Handoff CEX (clinical exercise) consists 6 subdomains 1 overall assessment, each scored from 9, where 3 is unsatisfactory 7 9 superior. We assessed range scores, performance among subgroups, internal consistency, agreement types raters. RESULTS We conducted 675 97 unique individuals during 149 sessions. Scores ranged superior in domain. The highest rated domain for providers was professionalism (median: 8; interquartile [IQR]: 7–9); the lowest content 7; IQR: 6–8). at 2 institutions were similar, scores did not differ significantly by training level. Spearman correlation coefficients provider 0.71 0.86, except setting (0.39–0.40). Third-party evaluators consistently gave lower marks same than did. Weighted kappa comparing peers 0.28 (95% confidence interval [CI]: 0.01, 0.56) 0.59 CI: 0.38, 0.80) organization. CONCLUSIONS This easily used trainees attendings, had high performed similarly across institutions. Because provided higher evaluators, this may be most appropriate evaluation. Journal Hospital Medicine 2013;8:191–200. © 2013 Society