Published On June 13, 2017
Patients in a hospital must necessarily pass from the care of one clinician to another. During these “handovers,” critical information about the patient also needs to be passed along. But errors can and do creep in. One study found that medication needs were omitted during 69% of handovers, and 22% of the time at least one clinically significant health problem was not mentioned.
A study in JAMA last December looked specifically at resident and intern rotations. When these doctors-in-training moved to their next specialization, and handed over patients to the next team, these patients were almost twice as likely to die, the study found.
Drawing a straight causality is problematic—patients who are sicker stay in the hospital longer and are therefore more likely to experience such a resident handover (which typically happens every four weeks). But it spurred a closer look at the importance of training young doctors to communicate.
“Most medical students and residents still receive little or no formal education in structured, standardized handover and communication techniques,” says David Shahian, vice president of quality and safety at Massachusetts General Hospital. Using the I-PASS model developed at Boston Children’s Hospital, Shahian and his colleagues have launched one of the country’s largest efforts to overhaul the way a hospital hands over patients—not only for residents but for the entire staff of 6,000 doctors, nurses and therapists.
A Better Transition
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