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Some Patients May Be Shortchanged During Hospital Shift Changes
Date:11/14/2012

WEDNESDAY, Nov. 14 (HealthDay News) -- Changing the way doctors and nurses exchange patient information during hospital shift changes could help improve care and save lives, a new study suggests.

These brief but important discussions can have a major impact on patient care in the early parts of a shift. Research has shown that miscommunication during these handoff conversations is a major contributing factor in preventable medical errors, according to the study authors.

The researchers analyzed 23 shift handoff sessions involving 262 patients at a Canadian hospital and found that doctors spend too much time talking about the first cases on their list and then rush those at the end of their list, even though those last cases might merit a longer discussion.

The doctors turned over between six and 23 patients in each of the shift handoff sessions and spent an average of 2.5 minutes per patient, but that varied widely. Doctors typically spent at least 50 percent longer discussing the first patient on the list than the last.

The average time spent discussing each patient declined steadily as the doctors moved down their lists, which were ordered by room number, according to the study published online Nov. 12 in the journal Archives of Internal Medicine.

Instead of using lists based on things such as patients' names or room and bed numbers, doctors and nurses should give priority to the patients that require the most discussion, the researchers suggested.

"I would expect that people could shift to talking about the sickest patients first, or the most unfamiliar or complex case," study lead author Michael Cohen, professor of complex systems, public policy and information at the University of Michigan, said in a university news release. "There isn't a one-size-fits-all remedy except to say the person handing off should begin by making a judgment of which patients need the most time."

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