Supporting the Characterization of Sign-Out in Acute Care Wards

Physician sign-out is a mechanism for transferring patient information, responsibility, and/or authority between care givers at a shift change. Despite being an important process, little research has examined the content and process of conducting sign-out. This paper describes the development and application of a support tool used to study and analyze physician sign-out. The tool supports the identification and analysis of 10 types of patient information, five types of physician communication, and three sources of distraction to physicians. The tool was applied during observations of sign-out on acute care pediatric wards to form a baseline of the current sign-out process and the information exchanged between physicians to identify areas in need of procedural support and training interventions.