Factors That Promote Perceived Usefulness of and Clinical Outcomes From Sign-Outs at the National University Hospital

IMPORTANCE OF THE STUDY. Currently, there is a paucity of evidence in the literature to show that handoff strategies improve the quality of handoff outcomes. Studies that show the usefulness and outcomes obtained from sign-outs may motivate junior clinicians, who have limited time to perform their clinical responsibilities, to support sign-out improvement efforts. OBJECTIVE. To test a research model that embeds the Technology Acceptance Model and the Theory of Planned Behavior to explore factors that enhance the perceived (a) usefulness of and (b) clinical outcomes from sign-outs among junior medical officers. DESIGN, SETTING, AND PARTICIPANTS. A retrospective study was conducted in the Division of General Medicine in November 2012. 17 residents volunteered to participate in a theoretically validated survey. MEASURES AND ANALYSES. The predictor variables were Perceived Ease of Sign-outs, Perceived Benefits from Sign-outs, Attitudes towards Sign-outs, Social Norms to Sign-out, and Perceived Behavior Control over Sign-outs. Partial Least Squares with bootstrapping to 1000 cases was utilized to analyze the data from a small sample. RESULTS. The results showed that perceived benefits from sign-outs enhanced the perceived usefulness of sign-outs. Perceived ease of sign-outs enhanced attitudes towards sign-outs, which was significantly related to perceptions of positive clinical outcomes from sign-outs. Neither the social pressure to sign-out nor the provision of conditions to facilitate sign-outs had any significant relationships to perceived usefulness of or clinical outcomes derived from sign-outs. CONCLUSION AND RELEVANCE. A two-prong approach involving minimal effort and hard evidence from clinical outcomes may be required to motivate adoption of sign-outs by