Impact of a computerized system on resident sign-out.

Communication problems between healthcare providers are the most common cause of preventable in-hospital disability and death. Some studies suggest electronic health records (EHRs) can improve communication between healthcare providers and decrease hospital mortality, complications, and costs. In this article, we describe our experience implementing a computer-based system in an effort to improve the effectiveness of patient-care hand-offs between resident physicians (signouts) at the University of Virginia Children’s Hospital. Sign-out is the transfer of information about a patient’s state and plan of care from one set of healthcare providers to another. Over the past decade, the number of sign-outs has increased while physician continuity of care during hospital stays has decreased. As a result, when caring for hospitalized patients, resident physicians have become increasingly dependent upon exchange of information during sign-out.