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The "Handoff" Are We Missing an Opportunity?

April 6, 2008
by James Feldbaum
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As medical care becomes more and more complicated and more care providers are involved in more settings the patient “handoff” becomes a critical component of safe medical care. Our electronic medical records up to now seem focused on the prevention of medication errors and CPOE while giving this critical element little direct attention.

Admittedly, increased access to information improves patient handoffs, but the medical record has the potential to do much more. The Department of Defense has created a comprehensive and thoughtful toolkit to improve the transition in care. It is not only a must-read for physicians and hospitals, but it creates a roadmap for software developers to greatly enhance the present state of the EMR.

Specifically, the challenge is to provide accurate patient information about a care plan, treatment, services provided, current condition, and any recent or anticipated changes in a patient's condition. The greatest opportunity occurs at the change of nursing shifts, physician transfer of complete responsibility for a patient, physician's transfer to on-call physicians, communication between specialists, communication between hospital units, and communication with nursing homes, outpatient clinics, and physician’s offices.

Clearly, there are non-electronic remedies that should be initiated in our present environment, but we should be harnessing the EMR to pull in appropriate data, display it in an intuitive and thoughtfully designed format, and make it available to the appropriate caregivers at the point of transitions.

Use this link to download the reference: http://www.feldbaum.com/handoff_toolkit.html

You can delegate authority, but not responsibility.

Stephen W. Comiskey

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James Feldbaum

Jim Feldbaum is a physician consultant specializing in clinical transformation, CPOE, and...