Utilizing information technology to mitigate the handoff risks caused by resident work hour restrictions

Area of Science:

• Medical Informatics
• Patient Safety
• Physician Education

Background:

• Resident duty hours are limited to 80 hours/week to enhance patient safety and physician sleep.
• Reduced work hours increase the frequency of patient handoffs between physicians.
• Increased handoffs correlate with a higher risk of medical errors.

Purpose of the Study:

• To explore the use of information technology to mitigate risks associated with increased patient handoffs.
• To propose solutions for improving the quality and safety of physician-to-physician patient information transfer.

Main Methods:

• Review of current challenges in resident duty hour policies and patient handoffs.
• Conceptualization of computer-based expert and "smart" systems for handoff support.
• Discussion of implementation barriers and potential solutions.

Main Results:

• Information technology can reduce errors by addressing data omissions, overload, asynchrony, and asymmetry.
• Smart systems can enhance physician understanding, facilitate multimedia use, and improve specialist interaction.
• Implementation faces challenges including HIPAA, legal issues, and costs.

Conclusions:

• Smart systems can supplement physician capabilities to mitigate handoff risks and advance patient care.
• Promoting smart handoff systems through initiatives by the Accreditation Council for Graduate Medical Education and Association of American Medical Colleges is recommended.
• A contest for developing and promoting superior smart handoff systems is proposed.