Saving lives could start at shift change – U-M researchers suggest a way to improve hospital handoffs

At hospital shift changes, doctors and nurses exchange crucial information about the patients they’re handing over—or at least they strive to. In reality, they might not spend enough time talking about the toughest cases, according to a study led by a researcher from the U-M School of Information and conducted at a hospital in Ontario, Canada.

These quick but important handoff conversations can have a major effect on patient care in the early parts of a shift. More than a half billion of them happen in U.S. hospitals every year, and that number has substantially increased with enforcement of work-hour regulations. Studies have shown that miscommunication during handoff conversations is a major contributing factor in preventable medical errors.

The new analysis of 23 handoff sessions involving 262 patients at a Canadian hospital revealed that doctors tend to use excessive time on early cases and rush at the end of the list, even though the last cases on the list might warrant more of their conversation time. The study authors suggest that doctors talk first about the patients that require the most discussion.

"I would expect that people could shift to talking about the sickest patients first, or the most unfamiliar or complex case. There isn’t a one-size-fits-all remedy except to say the person handing off should begin by making a judgment of which patients need the most time," said Michael D. Cohen, lead author of a paper on the work published online Nov. 12 in Archives of Internal Medicine.

For more information on this study, see

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