Abstract

VAZQUEZ, Andrea et al. Handoffs: relevant information and decision making in internal medicine: A prospective study. Educ. méd. [online]. 2011, vol.14, n.3, pp.181-187. ISSN 1575-1813.

Introduction. Handoffs are medical activity which transfers information and responsibility among professionals in situations of discontinuity or transitions in patient care. Handoffs are source of medical errors and adverse events, which despite the formal programming of specific competencies are absent in the curricula of medical residencies. In this sense, we implemented the educational project 'Oral and written handoffs in internal medicine residency program'. Materials and methods. We defined the parameter relevant information with a systemic item and four other cognitive items; we assess the prevalence of relevant information deficits and the effects on the clinical practice in a prospective study. Results. In 230 protocols the prevalence of relevant information deficits was 31.3% (n = 72) and affected both, systemic item (11%) as the cognitive items (20%). With relevant information, active behaviors were 34.6% and passive 65.4%; with relevant information deficits, the active behaviors were 13.9% and 86.1% passive respectively, this difference was significant (p < 0.001). Conclusions. We conclude that relevant information deficit is highly prevalent in the handoffs and results in errors of omission. The majority of medical errors recognize flaws in their own cognitive skills (cognitive errors) of clinical reasoning of physicians in training, so it is necessary to incorporate the oral and supervised handoffs at the residency curriculum.

Keywords : Communication skills; Internship and residency education; Medical education; Medical errors.

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