Residents are a big part of the medical system and their post grad training includes taking care of hospitalized patients. Typically, they do one month rotations on a hospital ward before transferring care to another resident and moving on.
A new study says those handovers can seriously harm the patients left behind.
There are probably several factors at play to explain why patients are at increased risk of dying following a handover. The fact that deaths occur more often when interns are involved suggests they lack experience at this sort of handover. They may be inadvertently omit important details about the patient and what to warn the incoming residents to watch for. More experienced residents may be better at avoiding such pitfalls because they’ve learned from participating in bad handovers.
Most hospitals have guidelines for daily handovers the ones that occur at the end of the day when the interns and residents sign over the care of their patients to the resident on call. Even so, there are problems with the quality of daily handovers. Few hospitals have written guidelines for monthly handovers. Quite often, the incoming resident takes over 15 to 20 patients without sitting down and meeting the departing team.
To fix this, the first step is for hospital authorities to acknowledge that poor monthly handovers threaten the safety of patients. Residents need to be taught, and interns need to be supervised through the process. Written guidelines will help, but they aren’t enough. The biggest gap is the lack of a face to face meeting between the outgoing and incoming residents to talk about each patient in front of the patient and the family so they can be part of the handover. The system needs to build in time for that meeting to take place, because as soon as the monthly rotation is over, the outgoing residents often depart for another hospital.
Full article at: CBC Radio