Nighttime clinical encounters: how residents perceive and respond to calls at night

Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine
Joshua T HansonReuben R McDaniel

Abstract

Care fragmentation is common and contributes to communication errors and adverse events. Handoff tools were developed to reduce the potential for these errors. Despite their widespread adoption, there is little information describing their impact on clinical work. Understanding their impact could be helpful in improving handoffs and transitions. To better understand what clinical work is done overnight, the housestaff perceptions of overnight clinical work, and how handoff instruments support this work. Real-time data collection and survey. Internal medicine resident physicians. Data collection measured information related to nighttime clinical encounters, including the information sources and actions taken. Surveys assessed resident perceptions toward care transitions. Of 299 encounters, 289 contained complete data. The tool was used as an information source in 27.7% of encounters, whereas the information source was either the nurse or the chart in 94.4% of encounters. Many encounters resulted in a new order for a medication, whereas 3.8% resulted in documentation. In the survey data, 73.6% residents reported the sign-out procedure was safe. These data suggest that a handoff tool is not sufficient to address nighttime clinical...Continue Reading

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Citations

Mar 5, 2015·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Christine D Jones, Jeffrey J Glasheen
Nov 13, 2015·BMJ Quality & Safety·Glenn RosenbluthAndrew D Auerbach
Mar 10, 2016·Hospital Pediatrics·Ross E NewmanKeith J Mann

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