Shift changes are a point of risk in hospital settings because as outgoing clinicians hand off patients to incoming staff, it is easy for important information to be missed or misunderstood. And this risk is heightened in the emergency setting, where providers are working under a constant state of urgency. "It is a fast and furious process in most EDs. No one really wants to admit that, but it is the truth," observes Drew Fuller, MD, MPH, FACEP, the director of safety innovation at Emergency Medicine Associates, (EMA), a Germantown, MD-based provider of medical services in the Mid-Atlantic region. "Most of what is done is what is called a hopeful handoff. You say what you have to say to the other clinician, and you hope that he or she got it all."
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