Omissions, Documentation Failures Associated with Morning Handover of On-Call Issues

August 6, 2014 | Strategic Insights for Health System


On-call residents omit as many as 40% of the clinically significant issues that occurred overnight during morning handovers to daytime staff, concludes a study published online July 21, 2014, in JAMA Internal Medicine. The study, which was conducted in the general internal medicine wards of two tertiary care academic medical centers in Ontario, Canada, in 2012 and 2013, identified 141 clinically important overnight issues during 26 days of observation. In addition to omitting 40% of these issues during the morning handover, trainees also failed to document any information in the patient's medical record for 86% of these issues—a strikingly low documentation rate that the researchers believe has important continuity-of-care and medicolegal implications.

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