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When patient handoffs go awry
Dr. Pauline Chen writes again; this time she covers "When patient handoffs go terribly wrong."
Dr. Pauline Chen writes: Like many others among my professional peers, I find myself signing out and my patients being handed off more than I ever thought would happen. While older patients with multiple chronic conditions will see up to 16 doctors a year, some of the healthiest younger patients I see count not only a primary care physician among their doctors but also a handful of specialists. Hospitalized patients, no longer cared for by their primary care doctors but by teams of fully trained doctors, or hospitalists, in addition to groups of doctors-in-training, are passed between doctors an average of 15 times during a single five-day hospitalization. And young doctors, with increasing time pressures from work hours reforms, will sign over as many as 300 patients in a single month during their first year of training.
While these changes have led to improvements in certain aspects of quality of care and better rested physicians, it has also resulted in frank fragmentation. It’s hardly surprising, then, that according to two recent studies, the vast majority of hospitalized patients are unable to name their doctor, and an equally large percentage of their discharge summaries have no mention of tests and studies that are pending.
To read the full article, click here: http://www.nytimes.com/2009/09/03/health/03chen.html?ref=health
