Improving Resident Satisfaction with Sign-Out by Implementing a Novel Transitions of Care Process

Brendan Pier, MD (McGaw Medical Center of Northwestern University (SRAL) PM&R Program, Chicago, Illinois); Alice Ye; Elizabeth E. Brown, MD; Christopher W. Lewis, MD; James A. Sliwa, DO; Monica E. Rho, MD; Mark Huang, MD, FAAPMR; Priya V. Mhatre, MD; Olumide Sokunbi, MD

Meeting: AAPM&R Annual Assembly 2022

Categories: Practice Management, Leadership, and Quality Improvement (2022)

Session Information

Session Title: Research Hub - Live Theater Research Spotlight: Late-Breaking Abstracts

Session Time: None. Available on demand.

Disclosures: Brendan Pier, MD: No financial relationships or conflicts of interest

Objective: Residents on call reported dissatisfaction with the sign-out process to and from primary inpatient teams (PITs). The objective was to implement a new sign-out system to improve the resident on call’s satisfaction with the process of evening and morning sign-out to and from the PITs.

Design: Prospective, unblinded, cross-sectional study at a single institution from July 2021 to April 2022.

Setting: Inpatient rehabilitation hospital

Participants: attending physicians, residents, advanced practice providers

Interventions: Residents on-call were dissatisfied with the format of handoff received from the PITs. The transitions of care committee developed a multi-faceted intervention, including creation of a universally accessible template in Microsoft OneNote where PITs could type their sign-out, as well as a comprehensive email listserv for disseminating the overnight sign-out back to the PIT members.

Main Outcome Measures: The primary outcome was resident on-call satisfaction with receiving handoff from the PITs. This was measured with a post-intervention survey, and results were compared to pre-intervention data. The main secondary outcome was the PIT member’s satisfaction with the new sign-out process.

Results: 46 post-intervention survey responses were collected from residents, attending physicians, and advanced practice providers. Resident on-call satisfaction with the sign-out process to and from the PITs was 27% prior to the interventions. After the sign-out interventions, resident on-call satisfaction with the sign-out to and from the PIT improved to 96%. Our secondary outcome, PIT satisfaction with the sign-out process to the resident on-call remained constant at 71%, but PIT satisfaction with the sign-out process from the resident on-call improved to 82%.

Conclusions: Implementation of a new sign-out process centered around a universally accessible OneNote template and an email listserv increased resident on-call satisfaction while having minimal change in the satisfaction of the PIT members. Future work may include quantifying medical error rates, preventable adverse events, or near misses after implementation of this new sign-out process.

Level of Evidence: Level III

To cite this abstract in AMA style:

Pier B, Ye A, Brown EE, Lewis CW, Sliwa JA, Rho ME, Huang M, Mhatre PV, Sokunbi O. Improving Resident Satisfaction with Sign-Out by Implementing a Novel Transitions of Care Process [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/improving-resident-satisfaction-with-sign-out-by-implementing-a-novel-transitions-of-care-process/. Accessed May 17, 2025.

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