In January 2018, attending supervised handoffs were implemented in the Neuro-ICU. On service neurointensivists were either physically or telepresent via the robot during handoffs at 6:30am and 5pm. Handoffs followed standard IPASS format, which providers had previously undergone department-led training in. After 3 months, surveys were administered to providers regarding the change in handoff practice.

The survey was completed by 37 providers. Prior to attending supervision, one third (32%) of respondents felt that handoffs never occurred in a quiet space and never followed IPASS format. Afterwards, all but one respondent answered that IPASS format was followed in a quiet environment most or all of the time. The majority (98%) felt that attendings clarified patient information or contingency plans during handoff, and overnight providers reported feeling more prepared after this change. Over 60% agreed or strongly agreed that having attending supervision has led to less miscommunications and improved patient safety. The most significant barrier identified was lack of time (52%).

The results of our survey found that after implementing attending supervision, handoffs became more structured and had less interruptions. Overall, respondents felt that there were less miscommunications, better provider preparedness, and improved patient safety. The main barrier to implementing a standardized handoff was lack of time followed by lack of interest. Further work to streamline an efficient handoff and educate providers about its importance is needed.