TY - JOUR T1 - Improving residents' handovers through just-in-time training for structured communication JF - BMJ Quality Improvement Reports JO - BMJ Qual Improv Report DO - 10.1136/bmjquality.u209900.w4090 VL - 5 IS - 1 SP - u209900.w4090 AU - Liam Rourke AU - Aditi Amin AU - Curtiss Boyington AU - Peter Ao AU - Natalia Frolova Y1 - 2016/01/01 UR - http://bmjopenquality.bmj.com/content/5/1/u209900.w4090.abstract N2 - In a recent quality assurance project we learned that nearly half of the handovers we examined were characterized as unsatisfactory by our residents, who provided examples in which their anxiety had been piqued and patient care had been affected. These reports substantiated a growing body of literature on the relationship between the quality of handover and the quality of patient care, so we sought to improve the quality and consistency of the in-hosptial handovers undertaken by our internal medicine residents. Senior residents attended morning report for three consecutive month long blocks and evaluated the quality of the handovers using an observational protocol comprised of 16 aspects of effective handover.During the first block, the resident observed a median of eight of the 16 practices occurring across the 46 handovers, and a large amount of variability. At the beginning of the subsequent block we presented a concise introduction to a structured handover procedure (SBARR). The median quality of the subsequent 33 handovers rose to 11, and the variability decreased considerably. In the next block we refined the SBARR orientation to focus on the errors observed in the previous blocks, and the improvement in the quality and variability was sustained. The minor change, which requires few resources to sustain, had a favourable impact on the quality of our residents' in-hospital handovers. ER -