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January 5, 2022 To Measure and Reduce Diagnostic Error, Start With the Data You Have

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Preventing Medical Errors During Handoffs

  • December 4, 2013

In Research and Publication
Communication errors are a leading cause of unexpected occurrences involving death or serious physical injury, or the risk of. This study, co-funded by CRICO, sought to determine whether or not the implementation of a handoff bundle could reduce errors and prevent adverse events among hospitalized children.


Conclusions: Given the increasing frequency of handoffs in hospitals following resident workhour reductions and the high frequency with which miscommunications lead to serious medical errors, disseminating high-quality handoff improvement programs has the potential for benefit. Improvements in verbal and written handoff processes occurred and resident workflow did not change adversely.

 

Read full-text of the article:

Starmer AJ, Sectish TC, Simon DW, Keohane C, McSweeney ME, Chung EY, Yoon CS, Lipsitz SR, Wassner AJ, Harper MB, Landrigan CP. Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundleJAMA. 2013 Dec 4;310(21):2262-70. doi:10.1001/jama. 2013.281961. PubMed PMID: 24302089.

 

Note: Co-author Carol Keohane joined CRICO as Assistant Vice President for CRICO’s Academic Medical Center’s Patient Safety Organization subsequent to the completion of this study.