Half-life of a printed handoff document

Area of Science:

• Medical Informatics
• Patient Safety
• Clinical Documentation

Background:

• Printed handoff documents are standard for provider communication during on-call shifts.
• These static documents are prone to rapid obsolescence due to ongoing patient management.
• Outdated information increases the risk of medical errors, particularly in services reliant on these documents.

Purpose of the Study:

• To quantify the average time until printed handoff documents become potentially inaccurate.
• To determine the 'half-life' of printed handoff information in a clinical setting.

Main Methods:

• A cross-sectional analysis was conducted on 100 adult inpatients over a 24-hour period.
• The 'half-life' was defined as the time at which 50% of patient information on printed documents would be expected to be inaccurate.
• Inaccuracy was determined by reviewing orders that update data fields on the handoff documents.

Main Results:

• The half-life of printed handoff documents was found to be 6 hours during the night shift and 3.3 hours during the day shift.
• At least one change occurred within 24 hours for 92% of patients.
• Medication-related changes accounted for 90% of updates, with significant differences in order types between day and night shifts (p=0.002).

Conclusions:

• The accuracy of printed handoff documents deteriorates rapidly during physician shifts.
• This rapid decay necessitates awareness of potential inaccuracies in patient data.
• A physician receiving sign-out for 20 patients overnight can expect half to have inaccurate data within 6 hours.