CONCEPTUAL FRAMEWORK FOR STUDYING SHIFT CHANGES AND OTHER TRANSITIONS IN CARE

摘要

In healthcare systems, division of labor and the need for continuous, 24 hour care subjects patients to multiple transitions in care. These transitions, or turnovers, are potential points of failure but have not been intensively studied. We observed care transitions in 5 EDs as part of a study on safety in emergency care and found that very different sorts of handovers occur in different settings. Based on these observations, we propose a conceptual framework for characterizing turnover events. The ability to characterize certain types of transitions may help clarify future studies and assist in crafting interventions to the context of work.