Utilizing information technology to mitigate the handoff risks caused by resident work hour restrictions.
Background: Resident duty hours have been restricted to 80 per week, a limitation thought to increase patient safety by allowing adequate sleep. Yet decreasing work hours increases the number of patient exchanges (so-called "handoff") at the end of shifts. WHERE ARE WE NOW?: A greater frequency of h...
| Publicado en: | Clinical Orthopaedics & Related Research® Vol. 468; no. 10; pp. 2627 - 2633 |
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| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Oct2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105104794&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105104794 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0009921X 23N jtl: Clinical Orthopaedics & Related Research® issn: 0009921X maglogo: N pubinfo: dt: Oct2010 vid: 468 iid: 10 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 105104794 NLM20458642 2010796484 10.1007/s11999-010-1376-7 NLM20458642 105104794 ppf: 2627 ppct: 6 formats: tig: atl: Utilizing information technology to mitigate the handoff risks caused by resident work hour restrictions. aug: au: Bernstein J MacCourt DC Jacob DM Mehta S Bernstein, Joseph MacCourt, Duncan C Jacob, Dan M Mehta, Samir affil: Department of Orthopaedic Surgery, Veterans Hospital, Philadelphia, USA sug: subj: Continuity of Patient Care Hand Off (Patient Safety) Hospital Information Systems Internship and Residency Medical Informatics Patient Record Systems Personnel Staffing and Scheduling Treatment Errors Prevention and Control Workload Cooperative Behavior Expert Systems Interprofessional Relations Multidisciplinary Care Team Risk Assessment Safety Time Factors ab: Background: Resident duty hours have been restricted to 80 per week, a limitation thought to increase patient safety by allowing adequate sleep. Yet decreasing work hours increases the number of patient exchanges (so-called "handoff") at the end of shifts. WHERE ARE WE NOW?: A greater frequency of handoff leads to an increased risk of physician error. Information technology can be used to minimize that risk. WHERE DO WE NEED TO GO?: A computer-based expert system can alleviate the problems of data omissions and data overload and minimize asynchrony and asymmetry. A smart system can further prompt departing physicians for information that improves their understanding of the patient's condition. Likewise, such a system can take full advantage of multimedia; generate a study record for self-improvement; and strengthen the interaction between specialists jointly managing patients. HOW DO WE GET THERE?: There are impediments to implementation, notably requirements of the Health Insurance Portability and Accountability Act; medical-legal ramifications, and computer programming costs. Nonetheless, the use of smart systems, not to supplant physicians' rational facilities but to supplement them, promises to mitigate the risks of frequent patient handoff and advance patient care. Thus, a concerted effort to promote such smart systems on the part of the Accreditation Council for Graduate Medical Education (the source of the duty hour restrictions) and the Association of American Medical Colleges (representing medical schools and teaching hospitals) may be effective. We propose that these organizations host a contest for the best smart handoff systems and vigorously promote the winners. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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