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Invited Critique
January 2011January 17, 2011

Teaching Residents to Pass and Catch the Baton: Comment on “Integration of a Formalized Handoff System Into the Surgical Curriculum”

Author Affiliations

Author Affiliation: Department of Surgery, Southern Illinois University School of Medicine, Springfield.

Arch Surg. 2011;146(1):93. doi:10.1001/archsurg.2010.278

Telem et al are to be congratulated not only for tackling an important, challenging change by implementing a formalized handoff system into a surgical curriculum but also for evaluating the outcomes in terms of effect on patient safety. Resident handoffs have increased 40% since the change in resident duty hours,1 and the hazards associated with transfer of information between multiple health care providers are well recognized.2 The authors evaluated SBAR as a model to provide a communication framework for resident handoffs for the 45 general surgery residents at their institution. Outcomes were evaluated by assessing sentinel events and resident order entry before and after training. Telem et al noted a significant 2.3% decrease in erroneous order entry, but there was no overall difference among controls who did not undergo SBAR training. Their findings were consistent with the literature finding that a leading cause of handoff failure is status asymmetry3,4