Docs report patient safety often at risk in ER to inpatient handoff

(HealthDay)—Physicians report that patient safety is often at risk during the emergency department admission handoff process due to ineffective communication. The findings were published online July 22 in the Journal of Hospital Medicine.

Christopher J. Smith, M.D., from the University of Nebraska Medical Center College of Medicine in Omaha, and colleagues surveyed resident, fellow, and faculty physicians directly involved in admission handoffs from emergency medicine and five medical admitting services at a 627-bed tertiary care academic medical center.

Based on responses from 94 admitting and 32 emergency medicine physicians, the researchers found that admitting physicians reported that vital clinical information was communicated less frequently for all content areas (P < 0.001), compared to emergency medicine physicians. Nearly all (94 percent) of emergency medicine physicians felt defensive at least "sometimes." Just under one-third of all respondents (29 percent) reported handoff-related adverse events, most frequently related to ineffective communication. Sequential handoffs were commonly reported for both emergency medicine and admitting services, and 78 percent of physicians reported that these handoffs negatively impact patient care.

"We identified several perceived barriers to safe inter-unit handoff from the emergency department to the inpatient setting. Handoff-related adverse events, a pattern of conflicting physician perceptions, and frequent sequential handoffs were of particular concern," the authors write. "Our findings support the need for collaborative efforts to improve interdisciplinary communication."

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