Physician Handoff of Patients: from the ICU to the Ward

Source : WSJ Health Blog

If you or a family member were unfortunate enough to have been hospitalized in an intensive care unit (ICU), did you ever wonder how your case was 'handed off' to another physician or medical team at the time of transfer out of the unit?
A recent paper in the American Journal of Medicine sheds some light on this topic. 

The underlying concern is that poor physician handoff may be a major contributor to suboptimal care and medical errors.


The investigators performed a hospitalized patient-based observational study in an urban, university-affiliated tertiary care center. The objective was to assess physician handoff practices for ICU-to-ward patient transfer. One hundred twelve adult patients were enrolled. The stakeholders (sending physicians, receiving physicians, and patients/families) were interviewed to evaluate the quality of communication during these transfers. 

During the initial stage of patient transfers, 15.6% of the consulted receiving physicians verbally communicated with sending physicians; 26% of receiving physicians received verbal communication from sending physicians when patient transfers occurred. Poor communication during patient transfer resulted in 13 medical errors and 2 patients being transiently "lost" to medical care. Overall, the levels of satisfaction with communication (scored on a 10-point scale) for sending physicians, receiving physicians, and patients were 7.9±1.1, 8.1±1.0, and 7.9±1.7, respectively.

Despite physician satisfaction with communication at the time of transfer, verbal communication between physicians appears uncommon (15-26%). Medical errors, albeit uncommon, occurred because of poor communication, these included, medication dosing and stoppage errors and diagnostic mistakes.

There is certainly room for improvement, especially for the sake of patient safety.

Here is more on the subject from the WSJ HealthBlog.