Handovers Among Staff Intensivists: A Study of Information Loss and Clinical Accuracy to Anticipate Events*

Objectives:
Handovers are associated with medical errors, and our primary objective is to identify missed diagnosis and goals immediately after a shift handover. Our secondary objective is to assess clinicians’ diagnostic accuracy in anticipating clinical events during the night shift.
Design:
Single-center prospective observational cohort study.
Setting:
Thirty-bed tertiary ICU in Sao Paulo, Brazil.
Patients:
Three-hundred fifty-two patient encounters over 44 day-to-night handovers.
Interventions:
None.
Measurements and Main Results:
We used a multimethods approach to measure transmission of information among staff physicians on diagnoses and goals for the night shift. We surveyed clinicians immediately after a handover and identified clinical events through chart abstractions and interviews with clinicians the next morning. Nighttime clinicians correctly identified 454 of 857 diagnoses (53%; 95% CI 50–56) and 123 of 304 goals (40%; 95% CI, 35–46). Daytime clinicians were more sensitive (65% vs 46%; p

Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Feature Articles Source Type: research