Patient communication during handovers between emergency medicine and internal medicine residents.

Abstract

Communication failures are a key cause of medical errors and are particularly prevalent during handovers of patients between services. To explore current perceptions of effectiveness in communicating critical patient information during admission handovers between emergency medicine (EM) residents and internal medicine (IM) residents. Study design was a survey of IM and EM residents at a large urban hospital. Residents were surveyed about whether critical information was communicated during patient handovers. Measurements included comparisons between IM and EM residents about their perceptions of effective communication of key patient information and the quality of handovers. Ninety-three percent of EM residents (50 of 54) and 80% of IM residents (74 of 93) responded to the survey. The EM residents judged their handover performance to be better than how their IM colleagues assessed them on most questions. The IM residents reported that one-half of the time, EM residents provided organized and clear information, whereas EM residents self-reported that they did so most of the time (80%-90%). The IM residents reported that 25% of handovers were suboptimal and resulted in admission to an inappropriate level of care, and 10% led to harm or delay in care. The EM residents reported suboptimal communication was less common (5%). On the global assessment of whether the admission handover provided the information needed for good patient care, IM residents rated the quality of the handover data lower than did responding EM residents. There are gaps in communicating critical patient information during admission handovers as perceived by EM and IM residents. This information can form the basis for efforts to improve these handovers.