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A Prospective Observational Study of Physician Handoff for Intensive-Care-Unit-to-Ward Patient Transfers - 18/08/11

Doi : 10.1016/j.amjmed.2011.04.027 
Pin Li, MD, MSc a, , Henry Thomas Stelfox, MD, PhD b, c, William Amin Ghali, MD, MPH a, c
a Department of Medicine, University of Calgary, Alberta, Canada 
b Department of Critical Care Medicine, University of Calgary, Alberta, Canada 
c Department of Community Health Sciences, University of Calgary, Alberta, Canada 

Requests for reprints should be addressed to Pin Li, MD, MSc, Department of Medicine, University of Calgary, Health Sciences Center, 3330 Hospital Drive NW, 3330 Hospital Drive NW, Room 1404, Calgary, AB T2N 1N4, Canada

Abstract

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.
 Conflict of Interest: None.
 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.


© 2011  Elsevier Inc. Reservados todos los derechos.
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Vol 124 - N° 9

P. 860-867 - septembre 2011 Regresar al número
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