"Ms. B changes doctors": using a comic and patient transition packet to engineer patient-oriented clinic handoffs (EPOCH)

J Gen Intern Med. 2015 Feb;30(2):257-60. doi: 10.1007/s11606-014-3009-4. Epub 2014 Sep 4.

Abstract

Background: Few patient-centered interventions exist to improve year-end residency clinic handoffs.

Aim: Our purpose was to assess the impact of a patient-centered transition packet and comic on clinic handoff outcomes.

Setting: The study was conducted at an academic medicine residency clinic.

Participants: Participants were patients undergoing resident clinic handoff 2011-2013 PROGRAM DESCRIPTION: Two months before the 2012 handoff, patients received a "transition packet" incorporating patient-identified solutions (i.e., a new primary care provider (PCP) welcome letter with photo, certificate of recognition, and visit preparation tool). In 2013, a comic was incorporated to stress the importance of follow-up.

Program evaluation: Patients were interviewed by phone with response rates of 32 % in 2011, 43 % in 2012 and 36 % in 2013. Most patients who were interviewed were aware of the handoff post-packet (95 %). With the comic, more patients recalled receiving the packet (44 % 2012 vs. 64 % 2013, p< 0.001) and correctly identified their new PCP (77 % 2012 vs. 98 % 2013, p< 0.001). Among patients recalling the packet, most (70 % 2012; 65 % 2013) agreed it helped them establish rapport. Both years, fewer patients missed their first new PCP visit (43 % in 2011, 31 % in 2012 and 26 % in 2013, p< 0.001).

Discussion: A patient-centered transition packet helped prepare patients for clinic handoffs. The comic was associated with increased packet recall and improved follow-up rates.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Continuity of Patient Care / standards*
  • Female
  • Follow-Up Studies
  • Humans
  • Pamphlets*
  • Patient Education as Topic / methods
  • Patient Education as Topic / standards*
  • Patient Handoff / standards*
  • Patient-Centered Care / methods
  • Patient-Centered Care / standards*
  • Physicians / standards*