title: Nurse practitioner-based sign-out system to facilitate patient communication on a neurosurgical service: a pilot study with recommendations.
abstract: Failure to communicate important patient information between physicians causes medical errors and adverse patient events. On-call neurosurgery physicians at the Toronto Western Hospital do not know the medical details of all the patients that they are covering at night because they do not care for the entire service of patients during the day. Because there is no formal handover system to transfer patient information to the on-call physician, a nurse practitioner-based sign-out system was recently introduced. Its effectiveness for communication was evaluated with preintervention-postintervention questionnaires and by recording daily logins. There was a statistically significant decrease in number of logins after 8 weeks of use (p = .05, Fisher's exact test), and the tool was abandoned after 16 weeks. Modifications identified to improve the system include the ability to sort by attending physician and to automatically populate the list with new patients. Effective communication is important for reducing medical errors, and perhaps these modifications will facilitate this important endeavor.
authors.affiliation: Department of Internal Medicine, Division of Psychiatry, University of Toronto, Canada. dlrabinov@hotmail.com
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Rabinovitch
authors.forename: Melinda
authors.initials: M
authors.lastname: Hamill
authors.forename: Clauda
authors.initials: C
authors.lastname: Zanchetta
authors.forename: Mark
authors.initials: M
authors.lastname: Bernstein
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D016494:Computer Security; D003266:Continuity of Patient Care / Q000458:organization & administration; D006801:Humans; D020407:Internet / Q000458:organization & administration; D019300:Medical Errors / Q000451:nursing / Q000517:prevention & control / Q000523:psychology; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D008505:Medical Staff, Hospital / Q000458:organization & administration / Q000523:psychology; D009493:Neurosurgery / Q000451:nursing / Q000458:organization & administration; D009551:Night Care / Q000458:organization & administration; D009722:Nurse Practitioners / Q000458:organization & administration / Q000523:psychology; D015403:Nursing Evaluation Research; D009864:Ontario; D019555:Physician-Nurse Relations; D010865:Pilot Projects; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D056164:Teaching Rounds / Q000458:organization & administration*; D017749:Total Quality Management / Q000458:organization & administration