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Handoffs and Transitions: Facilitating Communication Among Providers


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Handoffs and Transitions: Facilitating Communication Among Providers

Related to: Cures Act: Opening Notes, Emergency Medicine

In an effort to facilitate ownership and accountability for patients assumed by an oncoming ED shift, Maine Medical Center developed triggers for reassessment of boarding patients. These include time frames, e.g., visits longer than six hours, patients with altered mentation at time of sign out, or any concern raised by any member of the care team.

Although issues directly related to boarding are not common in ED malpractice cases, these patients raise justifiable concern and can drain resources away from patients with more acute needs. And, when an extended observation or boarding patient’s visit spans shift changes (sometimes multiple days), providers risk losing critical information at handoffs or fail to assume full accountability. Organizations that have been able to mitigate these risks employ communication protocols such as standardized transitions, coordinated nurse-physician sign outs, and second opinions at handoffs.

July 25, 2012
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