Evaluating Physician Stress During Patient Handoffs: Analysis of Physician Heart Rate Variability, Patient Handoff Characteristics, and ED Metrics

Patient handoffs represent a critical point in patient care, specifically in hospital Emergency Departments (EDs) where handoffs occur at every shift change. Previous studies have examined ED patient handoffs primarily by evaluating handoff communication methods and scheduling models that improve and reduce the prevalence of handoffs. In this study, we provided a quantitative analysis of physician stress by measuring the HRV of outgoing and oncoming physicians during patient handoffs. We recorded descriptive data of each observed patient handoff using the status of patient disposition as a measure of physician workload, and retrospectively gathered patient outcome and ED metric data for multivariate analysis. Results demonstrate that attending physicians experience increased HRV during handoff periods over non-handoff periods, with a significant increase observed in outgoing physicians (α = 0.05). This study creates a framework for future work that considers health care worker stress and evaluates ED handoffs via the stress and workload transferred between emergency physicians.