A Prospective Observational Study of Physician Handoff for Intensive-Care-Unit-to-Ward Patient Transfers - 18/08/11
, Henry Thomas Stelfox, MD, PhD b, c, William Amin Ghali, MD, MPH a, cAbstract |
Background |
Poor physician handoff can be a major contributor to suboptimal care and medical errors occurring in the hospital. Physician handoffs for intensive care unit (ICU)-to-ward patient transfer may face more communication hurdles. However, few studies have focused on physician handoffs in patient transfers from the ICU to the inpatient ward.
Methods |
We performed a hospitalized patient-based observational study in an urban, university-affiliated tertiary care center to assess physician handoff practices for ICU-to-ward patient transfer. One hundred twelve adult patients were enrolled. The stakeholders (sending physicians, receiving physicians, and patients/families) were interviewed to evaluate the quality of communication during these transfers. Data collected included the presence and effectiveness of communication, continuity of care, and overall satisfaction.
Results |
During the initial stage of patient transfers, 15.6% of the consulted receiving physicians verbally communicated with sending physicians; 26% of receiving physicians received verbal communication from sending physicians when patient transfers occurred. Poor communication during patient transfer resulted in 13 medical errors and 2 patients being transiently “lost” to medical care. Overall, the levels of satisfaction with communication (scored on a 10-point scale) for sending physicians, receiving physicians, and patients were 7.9±1.1, 8.1±1.0, and 7.9±1.7, respectively.
Conclusion |
The overall levels of satisfaction with communication during ICU-to-ward patient transfer were reasonably high among the stakeholders. However, clear opportunities to improve the quality of physician communication exist in several areas, with potential benefits to quality of care and patient safety.
El texto completo de este artículo está disponible en PDF.Keywords : Intensive care unit, Patient safety, Patient transfer, Physician communication
Esquema
| Funding: None. |
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| Conflict of Interest: None. |
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| Authorship: All 3 authors contributed equally to conceiving and designing the study, and analyzing and interpreting the data. Dr Li contributed data collection and writing the manuscript. Dr Stelfox provided critical revision and assisted in statistical analysis of data. Dr Ghali provided critical revision and final approval of the manuscript. All 3 authors had access to data. |
Vol 124 - N° 9
P. 860-867 - septembre 2011 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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