Wednesday, September 24, 20086
Patient handoffs
A major downside to capping resident work-hours is increasing the number of patient handoffs between doctors.
Further decreasing allowable work-hours to 56 hours per week will only exacerbate the problem.
A survey of MGH residents suggested that this practice led to significant patient harm, almost as serious as medication-related events:
Further decreasing allowable work-hours to 56 hours per week will only exacerbate the problem.
A survey of MGH residents suggested that this practice led to significant patient harm, almost as serious as medication-related events:
More than half of the 161 medical or surgical residents who responded to the anonymous survey said they recalled at least one occasion in their last month-long rotation when a patient suffered from flawed handoffs. About one in nine said the harm that resulted was significant.
Comments
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ERP
This is the time in the ER where most errors occur. Signout. Unfortunately, working 24 hours a day until the patient is discharged or dies is not a good option.
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Ileana
Or they can start standardizing their handoff process and making it better suited to changing shifts.
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Charles R.
Would not better, more specific, easily-scanned, electronic patient records help?
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Anonymous
Anecdotes are not data. Why do doctors refuse to believe this?
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Anonymous
A single-institution study is an anecdote? Ironic that anon cites another single-institution study as counterpoint. The following 2 studies are the real deal. Nothing beats national data when you're trying to evaluate the effect of a national intervention.
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Anonymous
Excuse me, the gall bladder study was in fact a study with real data, not a survey, which is the detritus of all empirical research.
Post a Comment12:16 PM
I know they are overworked and it's difficult to add yet another improvement process in the mix, but in the long run, you guys need to understand that residents need a life too and better rested residents with better handoff processes will eventually lead to fewer mistakes than before the 80 hours/week threshold.
1:11 PM
1:12 PM
Evidence suggests hour limits better for patients.
http://www.medicalnewstoday.com/articles/121683.php
2:34 PM
http://jama.ama-assn.org/cgi/content/abstract/298/9/975?ct
http://jama.ama-assn.org/cgi/content/short/298/9/984
9:52 AM
7:53 PM