Poor Sign-Outs = Worse Outcomes and Wasted Time

Many more sign-outs occur in academic teaching hospitals now that work-hour restrictions for resident physicians are enforced; however, the sign-out process still is rarely standardized. Most residents have no formal education in sign-out skills and are poorly supervised during this process. Retrospective studies suggest that inadequate sign-outs contribute to adverse events, less-efficient care, and prolonged lengths of stay for patients. However, we know little about the nature and incidence of transfer-related problems.

Researchers at Yale–New Haven Hospital addressed this question of transfer-related problems in 2006 by prospectively observing and audiotaping all sign-outs for 12 days (involving 8 internal medicine teams with 2 residents…