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Clinical errors are common during shift changes in a hospital setting.1-3 Clinicians on the outgoing shift may forget to communicate important details, such as medication dosages, critical laboratory orders, or other interventions, to the clinicians in the next shift. To help myself formally structure the sign-out process for each patient during a shift change in a psychiatric emergency room, I came up with the acronym COMPRESS for key questions to ask the outgoing provider:
Communicate. Did you communicate with this patient in any way at any time during your shift?
Orders. Did you write any orders for this patient? If not, had another clinician already written orders for this patient?
Medications. Did you review and reconcile the medication list for this patient? If not, had another clinician already reviewed and reconciled the medication list for this patient?
PRogrESs. Did you write a progress note for this patient? If not, had the attending clinician written a progress note for this patient within the last 24 hours?
Sign. Did you sign all of your orders and progress notes for this patient?
In my experience in the psychiatric emergency room, COMPRESS has helped me efficiently structure the outgoing clinicians’ reports about my patients by having them provide vital clinical sign-out information before they leave. I hope that other clinicians working in this setting also find these questions useful.
1. Dubosh NM, Carney D, Fisher J, et al. Implementation of an emergency department sign-out checklist improves transfer of information at shift change. J Emerg Med. 2014;47(5):580-585.
2. Estryn-Behar MR, Milanini-Magny G, Chaumon E, et al. Shift change handovers and subsequent interruptions: potential impacts on quality of care. J Patient Saf. 2014;10(1):29-44.
3. Mardis T, Mardis M, Davis J, et al. Bedside shift-to-shift handoffs: a systematic review of the literature. J Nurs Care Qual. 2016;31(1):54-60.
Clinical errors are common during shift changes in a hospital setting.1-3 Clinicians on the outgoing shift may forget to communicate important details, such as medication dosages, critical laboratory orders, or other interventions, to the clinicians in the next shift. To help myself formally structure the sign-out process for each patient during a shift change in a psychiatric emergency room, I came up with the acronym COMPRESS for key questions to ask the outgoing provider:
Communicate. Did you communicate with this patient in any way at any time during your shift?
Orders. Did you write any orders for this patient? If not, had another clinician already written orders for this patient?
Medications. Did you review and reconcile the medication list for this patient? If not, had another clinician already reviewed and reconciled the medication list for this patient?
PRogrESs. Did you write a progress note for this patient? If not, had the attending clinician written a progress note for this patient within the last 24 hours?
Sign. Did you sign all of your orders and progress notes for this patient?
In my experience in the psychiatric emergency room, COMPRESS has helped me efficiently structure the outgoing clinicians’ reports about my patients by having them provide vital clinical sign-out information before they leave. I hope that other clinicians working in this setting also find these questions useful.
Clinical errors are common during shift changes in a hospital setting.1-3 Clinicians on the outgoing shift may forget to communicate important details, such as medication dosages, critical laboratory orders, or other interventions, to the clinicians in the next shift. To help myself formally structure the sign-out process for each patient during a shift change in a psychiatric emergency room, I came up with the acronym COMPRESS for key questions to ask the outgoing provider:
Communicate. Did you communicate with this patient in any way at any time during your shift?
Orders. Did you write any orders for this patient? If not, had another clinician already written orders for this patient?
Medications. Did you review and reconcile the medication list for this patient? If not, had another clinician already reviewed and reconciled the medication list for this patient?
PRogrESs. Did you write a progress note for this patient? If not, had the attending clinician written a progress note for this patient within the last 24 hours?
Sign. Did you sign all of your orders and progress notes for this patient?
In my experience in the psychiatric emergency room, COMPRESS has helped me efficiently structure the outgoing clinicians’ reports about my patients by having them provide vital clinical sign-out information before they leave. I hope that other clinicians working in this setting also find these questions useful.
1. Dubosh NM, Carney D, Fisher J, et al. Implementation of an emergency department sign-out checklist improves transfer of information at shift change. J Emerg Med. 2014;47(5):580-585.
2. Estryn-Behar MR, Milanini-Magny G, Chaumon E, et al. Shift change handovers and subsequent interruptions: potential impacts on quality of care. J Patient Saf. 2014;10(1):29-44.
3. Mardis T, Mardis M, Davis J, et al. Bedside shift-to-shift handoffs: a systematic review of the literature. J Nurs Care Qual. 2016;31(1):54-60.
1. Dubosh NM, Carney D, Fisher J, et al. Implementation of an emergency department sign-out checklist improves transfer of information at shift change. J Emerg Med. 2014;47(5):580-585.
2. Estryn-Behar MR, Milanini-Magny G, Chaumon E, et al. Shift change handovers and subsequent interruptions: potential impacts on quality of care. J Patient Saf. 2014;10(1):29-44.
3. Mardis T, Mardis M, Davis J, et al. Bedside shift-to-shift handoffs: a systematic review of the literature. J Nurs Care Qual. 2016;31(1):54-60.
