title: Study: Cases discussed at the end of hand-off sessions get less time, regardless of complexity.
abstract: A new study shows that during shift changes, physicians tend to spend more time discussing cases at the beginning of the hand-off session than toward the end, regardless of the complexity of the case. In an analysis of 23 hand-off sessions involving 262 patients in an ICU setting, the researchers report that for hand-off sessions involving medium-sized groups of 11 patients, the time spent per case steadily declined as physicians moved down the list of patients, which was ordered by room number. While the study was done in the ICU, experts say the results are applicable to the ED as well as other hospital units. People tend to rush at the end of a hand-off session, they say. Researchers report that even when physicians are very experienced, they spend about 50% more time discussing cases at the beginning of a hand-off than on those that occur near the end. The problem impacts both nurses and physicians, say researchers, but they say it can be remedied easily. They advise clinicians handing-off patients to identify the cases that require the most time, and discuss them first.
mesh_terms: D003266:Continuity of Patient Care; D006302:Health Services Research; D007362:Intensive Care Units; D033183:Interdisciplinary Communication; D008824:Michigan; D062209:Patient Handoff / Q000458:organization & administration*; D013997:Time Factors