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Handoff Program Cuts Medical Errors, Adverse Events

Handoff Program Cuts Medical Errors, Adverse Events

Multifaceted program at children's hospital also increases physician time spent at patient bedside

THURSDAY, Dec. 5, 2013 (HealthDay News) -- Implementation of a multifaceted handoff program can reduce medical errors and preventable adverse events, according to a study published in the Dec. 4 issue of the Journal of the American Medical Association, a theme issue on medical education.

Amy J. Starmer, M.D., M.P.H., from Harvard Medical School in Boston, and colleagues examined whether implementation of a multifaceted handoff program correlates with reduced rates of medical errors and preventable adverse events in a prospective intervention study involving 1,255 patient admissions (642 before and 613 after the intervention) and 84 resident physicians (42 each before and after the intervention) in two units at Boston Children's Hospital. The intervention included a resident handoff bundle, comprising standardized communication and handoff training, a verbal mnemonic, and a new team handoff structure.

The researchers found that following the intervention there were significant decreases in medical errors (from 33.8 to 18.3 per 100 admissions; P < 0.001) and in preventable adverse events (from 3.3 to 1.5 per 100 admissions; P = 0.04). After the intervention, physicians spent a greater percentage of time in a 24-hour period at the patient bedside (8.3 versus 10.6 percent; P = 0.03). After the intervention, handoffs were significantly more likely to occur in a quiet location (33.3 versus 67.9 percent; P = 0.03) and private location (50.0 versus 85.7 percent; P = 0.007), although the average duration of verbal handoffs per patient did not change.

"Implementation of a handoff bundle was associated with a significant reduction in medical errors and preventable adverse events among hospitalized children," the authors write.

One author disclosed financial ties to academic and professional organizations.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1787406#Abstract )Full Text (http://jama.jamanetwork.com/article.aspx?articleid=1787406 )Editorial (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1787393 )