Theoretical framework | Evidence from night float case study | ACGME core competencies | Educational opportunities: applications to handoffs |
Costs of coordination | Communication failures; uncertainty during medical decision-making, “I did not know…” | Communication | Formal education in handoff communication with providers and patients, eg, SBAR |
Agency problem | Shift-work mentality, lack of responsibility to cross-cover patients, “Not my patient” | Professionalism | Establish handoffs as a transfer of professional responsibility, “Every patient is your patient” |