A 45-year-old man suffers multiple injuries in a motor vehicle accident. He undergoes several surgeries and has a long stay in the intensive care unit (ICU) complicated by hospital-acquired pneumonia, gastrointestinal bleeding, and deep venous thrombosis. After 30 days in the ICU, he is deemed ready to be transferred to the general medical ward. Which of the following is the most important aspect of patient handoff from the ICU team to medical team?

Question

A 45-year-old man suffers multiple injuries in a motor vehicle accident.  He undergoes several surgeries and has a long stay in the intensive care unit (ICU) complicated by hospital-acquired pneumonia, gastrointestinal bleeding, and deep venous thrombosis.  After 30 days in the ICU, he is deemed ready to be transferred to the general medical ward.  Which of the following is the most important aspect of patient handoff from the ICU team to medical team?

Quizplus · Accepted Answer

Explanation: 11ec2b69_bfe3_07be_8f63_5769b2c61a51_MD0005_00 A number of standardized procedures have been developed for safe and effective patient handoffs between providers (on the same clinical team or on different clinical services). All handoffs should contain pertinent information about the patient's demographics and clinical status, care plan, anticipated problems, and pending actions or results that require follow-up. Listing anticipated problems (and possible courses of action) is especially important as it allows the receiving providers to take faster, more effective action if any of these complications arise. (Choice A) Although avoiding redundancy can make handoffs quicker, including the proper information (eg, anticipated problems) is more important for high-quality patient care. For some high-risk processes (eg, drug allergies), incorporating redundancy into the system may in fact be preferable. (Choice B) Briefly relaying the patient's history and hospital course is important, but a detailed description of surgical procedures is excessive information that complicates effective patient handoffs, especially between non-surgical caregivers. (Choice C) Limiting verbal communication harms patient handoff as it does not give the receiving providers an opportunity to clarify and ask questions about the patient. Studies have shown that most effective handoffs occur when the various providers are face-to-face and have an opportunity to address any questions or concerns in real time. (Choice E) Ideally, handoffs should occur using a common standardized handoff tool. Changing the structure and flow of handoffs creates more errors due to the increased likelihood that important information will be excluded. Educational objective: Standardized procedures have been developed for safe and effective patient handoffs. All handoffs should contain pertinent information about the patient's demographics and clinical status, care plan, expected/anticipated problems, and pending actions or results that require follow-up. References: The Veterans Affairs shift change physician-to-physician handoff project. (http://www.ncbi.nlm.nih.gov/pubmed/20180438)

A 45-Year-Old Man Suffers Multiple Injuries in a Motor Vehicle