Use of a Cognitive Aid during Simulated Patient Crisis Improves the Quality of the Transition of Care Process

Background: Transition of care (ToC) is a critical time when pertinent patient information can be lost between providers, potentially effecting outcomes.Objective: The aim of this research was to assess: a) Anesthesiology residents' completeness of ToC in a crisis situation, and b) whether using a cognitive aid might improve the ToC.Methods: Simulation scenarios were developed for anesthesiology residents to lead a team through a crisis situation, perform a ToC to the critical care team without a cognitive aid (Baseline), and a similar scenario 10 months later with a Cognitive Aid (CA).In the simulated scenario, the residents responded to a deteriorating patient, stabilized the patient, and transferred care to the critical care provider.Residents then completed a questionnaire to assess patient information retention.Faculty from two institutions reviewed the recordings to assess completeness and quality of the ToC.Results: Out of 36 PGY2-4 anesthesiology residents, 14 participated (39%).Resident questionnaire results after the Baseline simulation indicated that residents were able to recall 65.7±17.9% of patient information.Use of the CA increased the percentage of correct answers to 91.4 ± 9.5% (p<0.01).During baseline assessment, approximately 30% of pertinent patient information was lost during the ToC.The use of a CA 10 months later was associated with a significant increase in the CS by 0.19±0.08(p=0.02) and overall quality of the ToC.Conclusion: Critical patient information transfer was more complete and higher quality in the ToC process of a simulated patient crisis when residents used a cognitive aid.