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227 Communication Breakdown: Perceptions of the Patient Handover Process between Emergency Medicine and Internal Medicine

2011; Elsevier BV; Volume: 58; Issue: 4 Linguagem: Inglês

10.1016/j.annemergmed.2011.06.256

1097-6760

Stuart Marshall, Tracey L. Adams, M Fischer, Kara J. Mould, Mājid Shafiq, Chung Sang Tse, Eva Rimler, Philip Shayne, Sally A. Santen,

Healthcare Systems and Technology

To determine current perceptions on the efficacy and quality of communication during the handover process between internal medicine (IM) and emergency medicine (EM) residents. This study was conducted at a large, urban academic hospital. A cohort of IM and emergency medicine residents were surveyed on their perceptions of the current handover process used for the transfer of patient care. The survey was developed and validated by faculty experts and administered anonymously to residents using the Survey Monkey ® data collection tool. Residents who worked in the emergency department or on the general medicine inpatient ward service at the study site within 6 months prior to survey release were included in the study. Survey results between the 2 groups were analyzed using SPSS (version 18.0) for t-tests comparison of means. This study was reviewed by the IRB. A total of 54 emergency medicine residents and 93 IM residents were eligible to participate. The response rate was high with 124 (84%) residents completing the survey. In general, when compared to their IM counterparts, emergency medicine residents had a much more positive perception on the quality of information they relayed during the patient handover process. IM residents believed that handover information was relayed in an organized manner around half (52%) of time, while emergency medicine residents felt as if they did this most (80%) of the time. There was a similar discordance of opinions regarding how frequently the handover information was communicated clearly. Furthermore, IM residents felt that nearly a fifth of handovers were suboptimal, resulting in either an admission to an inappropriate level of care, a delay in care or patient harm. In comparison, the emergency medicine residents felt this occurred infrequently (less than 10%). Both groups, however, agreed that residents maintained a professional conduct during the handover process and that interruptions were infrequent. The patient handover is a critical aspect of patient care and when performed well can prevent medical errors and ensure patient safety. There is a clear discrepancy in the perception of the efficacy and quality of patient handoffs between emergency medicine and internal medicine. As the results indicate, miscommunication and misunderstanding seem to be the core problems affecting the patient handover process. This study illustrates the need for an effective handover protocol that allows emergency physicians to deliver and IM physicians to receive essential patient information that is needed to provide accurate, high quality care.Tabled 1