Answering questions on call: Pediatric resident physicians' use of handoffs and other resources. Issue 6 (16th April 2013)

• Record Type: Journal Article
• Authors: McSweeney, Maireade E.; Landrigan, Christopher P.; Jiang, Hongyu; Starmer, Amy; Lightdale, Jenifer R.
• Is Part Of: Journal of hospital medicine. Volume 8:Issue 6(2013)
• Page Start: 328
• Page End: 333
• Publication Date: 2013-04-16
• Subjects: Hospital care -- Periodicals; Clinical medicine -- Periodicals; 610
• DOI: 10.1002/jhm.2038
• Languages: English
• ISSNs: 1553-5592

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jhm2038-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>Little is known in the literature about the types of questions being asked of on‐call housestaff and the resources used to provide answers.</p> </sec> <sec id="jhm2038-sec-0002" sec-type="section"> <title>OBJECTIVE</title> <p>To characterize questions being asked of pediatric interns on call and evaluate their use of written handoffs, verbal handoffs, and other resources.</p> </sec> <sec id="jhm2038-sec-0003" sec-type="section"> <title>DESIGN/METHODS</title> <p>Prospective direct observational study.</p> </sec> <sec id="jhm2038-sec-0004" sec-type="section"> <title>SETTING</title> <p>Inpatient wards at an academic tertiary care children's hospital.</p> </sec> <sec id="jhm2038-sec-0005" sec-type="section"> <title>PARTICIPANTS</title> <p>Pediatric interns.</p> </sec> <sec id="jhm2038-sec-0006" sec-type="section"> <title>RESULTS</title> <p>Trainees were asked 2.6 questions/hour (interquartile range: 1.4–4.7); most involved medications (28%), general care plans (27%), diagnostic tests/procedures (22%), diet/fluids (15%), and physical exams (9%). Interns reported using information provided in written or verbal handoffs to answer 32.6% questions (written 7.3%; verbal 25.3%). Other resources utilized included general medical knowledge, the medical record, and parental report. Questions pertaining to diet/fluids were associated with increased written handoff use (odds ratio [OR]: 3.64, 95% confidence interval [CI]: 1.51–8.76), whereas having worked more consecutive nights was associated with decreased written handoff use (OR: 0.29, 95% CI: 0.09–0.93). Questions regarding general care plans (OR: 2.07, 95% CI: 1.13–3.78), those asked by clinical staff (OR: 1.95, 95% CI: 1.04–3.66), and questions asked of patients with longer lengths of stay (OR: 1.97, 95% CI: 1.02–3.80) were predictive of verbal handoff use.</p> </sec> <sec id="jhm2038-sec-0007" sec-type="section"> <title>CONCLUSIONS</title> <p>Pediatric housestaff face frequent questions during overnight shifts and frequently use information received during handoffs to provide answers. A better understanding of how handoffs and other resources are utilized by housestaff could inform future targeted initiatives to improve trainees' access to key information at night. <italic>Journal of Hospital Medicine</italic> 2013;8:328–333. © 2013 Society of Hospital Medicine</p> </sec> </abstract>