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01-02-2015 | Innovation and Improvement: Innovations in Medical Education

“Ms. B Changes Doctors”: Using a Comic and Patient Transition Packet to Engineer Patient-Oriented Clinic Handoffs (EPOCH)

Authors: Amber T. Pincavage, MD, Wei Wei Lee, MD MPH, Laura Ruth Venable, BS, Megan Prochaska, MD, Daina D. Staisiunas, JD, Kimberly J. Beiting, BA, M. K. Czerweic, RN MA, Julie Oyler, MD, Lisa M. Vinci, MD MS, Vineet M. Arora, MD MAPP

Published in: Journal of General Internal Medicine | Issue 2/2015

ABSTRACT

BACKGROUND

Few patient-centered interventions exist to improve year-end residency clinic handoffs.

AIM

Our purpose was to assess the impact of a patient-centered transition packet and comic on clinic handoff outcomes.

SETTING

The study was conducted at an academic medicine residency clinic.

PARTICIPANTS

Participants were patients undergoing resident clinic handoff 2011–2013

PROGRAM DESCRIPTION

Two months before the 2012 handoff, patients received a “transition packet” incorporating patient-identified solutions (i.e., a new primary care provider (PCP) welcome letter with photo, certificate of recognition, and visit preparation tool). In 2013, a comic was incorporated to stress the importance of follow-up.

PROGRAM EVALUATION

Patients were interviewed by phone with response rates of 32 % in 2011, 43 % in 2012 and 36 % in 2013. Most patients who were interviewed were aware of the handoff post-packet (95 %). With the comic, more patients recalled receiving the packet (44 % 2012 vs. 64 % 2013, p< 0.001) and correctly identified their new PCP (77 % 2012 vs. 98 % 2013, p< 0.001). Among patients recalling the packet, most (70 % 2012; 65 % 2013) agreed it helped them establish rapport. Both years, fewer patients missed their first new PCP visit (43 % in 2011, 31 % in 2012 and 26 % in 2013, p< 0.001).

DISCUSSION

A patient-centered transition packet helped prepare patients for clinic handoffs. The comic was associated with increased packet recall and improved follow-up rates.

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Young JQ, Wachter RM. Academic year-end transfers of outpatients from outgoing to incoming residents: an unaddressed patient safety issue. JAMA. 2009;302(12):1327–9.PubMedCrossRef

Young JQ, Eisendrath SJ. Enhancing patient safety and resident education during the academic year-end transfer of outpatients: lessons from the suicide of a psychiatric patient. Acad Psychiatry. 2011;35(1):54–7.PubMedCrossRef

Pincavage AT, Ratner S, Prochaska ML, Prochaska M, Oyler J, Davis AM, Arora VM. Outcomes for resident-identified high-risk patients and resident perspectives of year-end continuity clinic handoffs. J Gen Intern Med. 2012;27(11):1438–44.PubMedCentralPubMedCrossRef

Caines LC, Brockmeyer DM, Tess AV, Kim H, Kriegel G, Bates CK. The revolving door of resident continuity practice. Identifying gaps in transitions of care. J Gen Intern Med. 2011;6(9):995–8.CrossRef

Pincavage AT, Lee W, Beiting KJ, Arora VM. What do patients think about year-end resident continuity clinic handoffs? A qualitative study. J Gen Intern Med. 2013;28(8):999–1007.PubMedCentralPubMedCrossRef

Roy MJ, Kroenke K, Herbers JE Jr. When the physician leaves the patient: predictors of satisfaction with the transfer of primary care in a primary care clinic. J Gen Intern Med. 1995;10(4):206–10.PubMedCrossRef

Garment AR, Lee W, Harris C, Phillips-Caesar E. Development of a structured year-end sign-out program in an outpatient continuity practice. J Gen Intern Med. 2013;28(1):114–20.PubMedCentralPubMedCrossRef

Donnelly MJ, Clauser JM, Weissman NJ. An intervention to improve ambulatory care handoffs at the end of residency. J Grad Med Educ. 2012;4(3):381–4.PubMedCentralPubMedCrossRef

Pincavage AT, Dahlstrom M, Prochaska M, Ratner S, Beiting KJ, Oyler J, Vinci LM, Arora VM. Results of an enhanced clinic handoff and resident education on patient ownership and patient safety. Acad Med. 2013;88(6):795–801.PubMedCrossRef

10.

Pincavage AT, Prochaska ML, Dahlstrom M, Lee W, Beiting KJ, Ratner S, Oyler J, Vinci LM, Arora VM. Patient safety outcomes after two years of an enhanced internal medicine residency clinic handoff. Am J Med. 2014;127(1):96–9.PubMedCrossRef

11.

Roy MJ, Herbers JE, Seidman A, Kroenke K. Improving patient satisfaction with the transfer of care. A randomized controlled trial. J Gen Intern Med. 2003;18(5):364–9.PubMedCentralPubMedCrossRef

12.

Institute of Medicine (IOM). Committee on Health Care in America. Crossing the quality chasm: a new health system for the 21st century. National Academy Press: Institute of Medicine. 2001.

13.

Agency for Healthcare Research and Quality and National Institute of Mental Health. Program announcement. Patient-centered care: customizing care to meet patients’ needs. 2001, July 31. Web site: http://grants.nih.gov/grants/guide/pa-files/PA-01-124.html. Accessed July 11, 2014.

14.

Accreditation Council for Graduate Medical Education (ACGME). ACGME program requirements for graduate medical education in internal medicine. Available at: http://www.acgme.org/acgmeweb/tabid/134/ProgramandInstitutionalAccreditation/MedicalSpecialties/InternalMedicine.aspxAccessed July 11, 2014.

15.

Pincavage AT, Ratner S, Lee WW, Oyler J, Arora VM. Innovating education to improve year-end resident continuity clinic handoffs. Acad Intern Med Insight. 2012;10:8–9. 11.

16.

Pincavage AT, Lee W, Ratner S, Prochaska M, Davis A, Saathoff M, Arora V. Teaching Video and Workshop Exercises: "Putting the Patient First: Engineering Patient-Oriented Clinic Handoffs (EPOCH)". MedEdPORTAL; 2014. Available from: www.mededportal.org/publication/9686. Accessed July 11, 2014.

17.

STATA 21 11.0 (College Station, TX).

Title: “Ms. B Changes Doctors”: Using a Comic and Patient Transition Packet to Engineer Patient-Oriented Clinic Handoffs (EPOCH)
Authors: Amber T. Pincavage, MD
Wei Wei Lee, MD MPH
Laura Ruth Venable, BS
Megan Prochaska, MD
Daina D. Staisiunas, JD
Kimberly J. Beiting, BA
M. K. Czerweic, RN MA
Julie Oyler, MD
Lisa M. Vinci, MD MS
Vineet M. Arora, MD MAPP
Publication date: 01-02-2015
Publisher: Springer US
Published in: Journal of General Internal Medicine / Issue 2/2015
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-014-3009-4

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ABSTRACT

BACKGROUND

AIM

SETTING

PARTICIPANTS

PROGRAM DESCRIPTION

PROGRAM EVALUATION

DISCUSSION

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