The Patient Handoff: Communication between Primary Physicians and Hospitalists

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The Patient Handoff: Communication between Primary Physicians and Hospitalists. Julia S. Wright, M.D. July 11, 2007. Primary Care-Hospitalist Patient Sharing. Division of Labor Quality of care Medicolegal Physician Interaction Continuity - PowerPoint PPT Presentation

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  • The Patient Handoff: Communication between Primary Physicians and HospitalistsJulia S. Wright, M.D.July 11, 2007

  • Primary Care-Hospitalist Patient SharingDivision of LaborQuality of careMedicolegalPhysician InteractionContinuityHandoff: transfer of patient care responsibility from outpatient to inpatient MD. Note: Intervention Independent

  • Goals of HandoffEffective information transferCommunication system providing timely, accurate, thorough information

  • Deficits in Communication and Information Transfer Between Hospital-Based and Primary Care Physicians: Implications for Patient Safety and Continuity of Care. Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. JAMA, 2007;297(8):831-841.

  • Information gapSuggested decreased quality of care at followup and adverse outcomes if poor information transfer occurs.Literature review of deficits of information transfer at discharge, and interventions to improve them.

  • Primary physicians report limited role.
  • Content: PMD Ratings of Desired InformationMain diagnosisPertinent physical findingsResults of procedures/testsDischarge meds with reason for changesFollowup arrangementsPending tests and specific followup needs (*)Information given to patient/family

  • ConclusionsCommunication and information transfer is often suboptimal

    Interventions had limited effect on outcomes. Options for handoff policies and procedures: white papers and discussions

  • Recommendations:

    Kripalani S, LeFevre F, Phillips CO, et al. JAMA, 2007;297(8):838

  • Obligations of both physicians- patient care/continuity/information

    Contact and communication between physicians

    Information exchangeFrequencyModeValue: respect and support, education

    Actions: Hospital-based change? Hospitalist policy; pager 6677Discussion Issues

  • Thorough dictations, templatesContacting Primary PhysicianHospitalist BrochureHandoff Policy: internal and referralHospitalist Measures

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