University of Chicago Medical Center
Internal Medicine Residency Program
Transitions of Care Policy

Purpose

The term “Transition of Care” addresses the transfer of information, authority and responsibility to ensure
continuity and safety for a patient. ACGME has charged both sponsoring institutions and individual
programs with designing clinical assignments to minimize the number of transitions in patient care as
well as to ensure that residents are competent in communicating with team members in the hand-over
process. Language and processes described in this policy are intended:

  • To ensure continuity of care and patient safety while minimizing the number of transitions;
  • To describe the process by which (a) resident-to-resident transitions, (b) resident to other
    personnel transitions and (c) oversight by faculty will occur; and
  • To facilitate effective communication among all individuals or teams with responsibility for
    patient care.

Policy

Clinical assignments will be designed to minimize the potential for errors and ineffective communication
regarding an individual patient’s current status and intended care delivery over the subsequent
management period. Whenever possible, transitions will occur at a uniform daily time to minimize
confusion.
A checklist developed to ensure appropriate communication of relevant information will be utilized to
assure complete and accurate resident-to-resident patient transitions. At a minimum, elements of the
checklist include:
 Patient name;
 Age;
 Room or other location number;
 Patient ID number;
 Name and contact number for responsible resident and attending physician
 Pertinent diagnoses;
 Relevant allergies;
 Pending critical laboratory and imaging studies;
 Overnight (or next period) care issues with a ‘to do’ list including follow up on laboratory and
imaging studies;
 Resuscitation status; and
 Other items appropriate for the particular situation.
A structured face-to-face, phone-to-phone, or secure intra-hospital electronic communication will occur
for each patient care transition. At a minimum, this process will incorporate a process for interactive
questions. All communication will be provided in a manner consistent with protecting patient
confidentiality.
Faculty oversight of the transition process will occur directly or indirectly, depending upon resident level,
experience and documented ability to conclude an effective transition.
The program will undertake periodic assessment of transitions of care effectiveness. In addition,
continuous monitoring of residents’ knowledge, application and effective communication while engaging
in transition activities will occur.