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Proc Annu Symp Comput Appl Med Care. 1992 : 114–118.
PMCID: PMC2248075

Signing out patients for off-hours coverage: comparison of manual and computer-aided methods.


This paper evaluates the communication of information to physicians who provide off-hours coverage to inpatients in two Family Practice residency programs. METHOD: To describe the importance and accessibility of clinical information used by on-call residents in covering hospital patients, we administered a questionnaire. Then following the use of a new computerized sign-out system in one of the programs, residents filled out the same questionnaire again. RESULTS: Residents felt that a "to do" list and information about the patient's "code status" were the most important data desired from sign-out sheets. However, 69% of residents in both programs felt that provision of this information was normally poor. Nearly all of the residents in Buffalo, using an entirely handwritten sign-out sheet, felt it was in need of improvement. Residents in Pittsburgh, using a summary aided by the hospital's computer print-out, felt this need much less acutely. After implementation of a new computerized sign-out sheet in Buffalo, residents indicated a slightly higher level of satisfaction. The work of data entry and re-entry into the computer was unpopular and inefficient. CONCLUSION: The present method of transferring information at the end of a work day is not satisfactory for residents. Provision of data summaries from existing hospital information systems is a good first step in improving data transfer. A further study of more comprehensive automated sign-out systems is important, because of the increasing discontinuity of house officer care.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Thorpe KE. House staff supervision and working hours. Implications of regulatory change in New York State. JAMA. 1990 Jun 20;263(23):3177–3181. [PubMed]
  • Stead WW, Hammond WE. Computer-based medical records: the centerpiece of TMR. MD Comput. 1988 Sep-Oct;5(5):48–62. [PubMed]
  • McDonald CJ, Blevins L, Tierney WM, Martin DK. The Regenstrief medical records. MD Comput. 1988 Sep-Oct;5(5):34–47. [PubMed]

Articles from Proceedings of the Annual Symposium on Computer Application in Medical Care are provided here courtesy of American Medical Informatics Association