Utilization of morning report by acute care surgery teams: results from a qualitative study

BACKGROUND: The rigor of handoffs is increasingly scrutinized in the era of shift-based patient care. Acute care surgery (ACS) embraced such a model of care; however, little is known about handoffs in ACS programs. METHODS: Eighteen open-ended interviews were conducted with ACS leaders representing diverse geographic and practice settings. Two independent reviewers analyzed interviews using an inductive approach to elucidate themes regarding use of morning report (using NVivo qualitative analysis software). RESULTS: Twelve of 18 respondents reported using morning report, but only 6 of 12 included attending surgeon-to-attending surgeon handoffs. One of 12 incentivized attending surgeons to participate, 2 of 12 included nursing staff members, and 2 of 12 included physician extenders. Cited benefits of morning report were safe and effective information exchange (2 of 12), quality improvement (2 of 12), multidisciplinary discussion (1 of 12), and resident education (2 of 12). Three of 12 respondents cited time commitment as the main limitation of morning report. CONCLUSIONS: Morning report is underused among ACS programs; however, if implemented strategically, it may improve patient care and resident education. (C) 2013 Elsevier Inc. All rights reserved.