How poor physician communication leads to medical mistakes

Communication errors can arise when patients are transferred from the emergency department to the medical floor.

Because of a “fundamental disconnect of expectations,” between the emergency department and hospitalists, there can be confusion as to who is responsible for the patient. Information may not be communicated as clearly as it should, potentially leading to medical errors.

After an emergency physician “signs out” a patient, “the ED doctor is mentally finished with that patient and moves on. If his shift ends before the patient goes up to the floor, it’s even worse.” It’s a dangerous mentality, since many patients remain in the ED after sign out due to crowding on the medical floors.

The whole issue is another byproduct of emergency department crowding. Visits are up and EDs are closing, putting pressure on hospitals to increase patient turnover. Hospitalists are “admitting and discharging faster and faster.”

Clearly communicating who is responsible for the patient after sign out is key. For instance if there are pending test results, spell out who will follow-up on them.

Dr. RW suggests regular meetings between the two departments to solve any residual communication gaps.

Update:
Emergency physician Shadowfax responds.

topics: hospitalists, emergency

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  • drbobbs

    “The whole issue is another byproduct of emergency department crowding.” Which is itself a byproduct of there being far too few primary care physicians. Many of these ER visits could be taken care of in a family medicine or internal medicine office. Or the conditions would not have progressed to the point that they require the services of an ER doc.

    But we didn’t (and still don’t) want to pay primary care physicians enough money to attract med students to pursue that sort of career.

    The chickens have come home to roost.