Although recent research has focused on problems for patients arising from daily shift changes, a new study finds that monthly handoffs between residents may present opportunities for more lasting, negative outcomes.
"Most hospitals have guidelines for the handoffs that occur on a daily basis, and usually those handoffs include a face-to-face discussion between doctors about what will happen to the patient during the next shift," Joshua Denson, MD, lead researcher on a study to be presented at the American Thoracic Society's 16th annual conference in San Francisco on May 17, said in a statement. "But few have guidelines for this monthly handoff, in which a resident turns over for good the care of 10 to 20 patients, often in an email or telephone conversation."
The authors identified an in-hospital mortality increase of between 64 and 95 percent for patients caught in the monthly handoff, a 76 to 92 percent increase in 30-day mortality, and a 72 to 84 percent 90-day mortality increase.
Dr. Denson suggests this downstream impact on mortality could stem from discharge or medications errors that result from the new resident lacking a complete picture of patients' situations.