Does improving handoffs reduce medical error rates?

摘要

In 1965, the American Medical Association declared that “An intern’s duties and responsibilities are not discharged on a ‘nine-to-five’ basis. While an acceptable internship provides for a reasonable amount of free time, [the intern’s] thought for and contact with his patients should be on a ‘round-the-clock’ basis.”1 In the intervening 45 years, the advent of the hospitalist movement fragmented inpatient and outpatient care, payment by diagnosis reduced length of stay, hospitalization rates per capita increased by 15%,2 and more than 1000 new drug applications were approved.3 In short, inpatient care is now more fragmented, more frantic, and more complicated than in the 1960s.