ED Crowding Not a Factor in Omissions during Patient Handoff Communications

Providers failed to communicate the presence of hypotension or hypoxia during almost one in seven patient handoffs in the emergency department (ED), concludes a study published in the August 2015 issue of Annals of Emergency Medicine. The researchers observed 1,163 patient handoffs during 130 ED shift rounds at an urban academic hospital and found that, of 117 patients with episodes of hypotension and 156 patients with hypoxia, this information was only communicated during shift change for 66 (42%) and 116 (74%), respectively. The data revealed that providers were interrupted by verbal cutoffs during handoff communication in 49% of handoffs and interrupted for patient care issues in 6% of handoffs. In addition, handoffs initiated by senior residents were more likely to omit mention of hypotension or hypoxia than those initiated by junior residents or attending physicians.