There’s a risk of medical errors and malpractice when a patient is handed off from one physician to another.
If communication is not good, a physician may fail to convey vital information or care can fall through the cracks. Take the case of a woman whose cancer diagnosis was delayed for a year because her lab result was entered into the electronic health record, Medscape reports, but was never flagged to her primary care doctor.
That was one of the cases examined by CRICO Strategies, a research and analysis division of the company that insures Harvard-affiliated hospitals, which looked at more than 23,000 medical malpractice claims in 2015. In about 30% of the case, there was a breakdown in communication and it was not uncommon for facts, figures or findings to get lost between providers. The result was 1,700 deaths and $1.7 billion in malpractice settlements.
So what can doctors do to solve the problem? The Medscape article suggests physicians:
Recognize that electronic health records (EHR) can contribute to the problem. For instance, a doctor puts a note in the EHR and assumes another doctor will see it. However, important information can get lost in all the data required in the electronic system.
Make sure you create a culture where staff are not afraid to speak up or ask questions. For instance, a patient has a latex allergy but a nurse is afraid to speak up to a doctor who puts on latex gloves. At the American College of Healthcare Executives’ 2017 Congress on Healthcare Leadership earlier this year, patient safety expert James P. Bagian, M.D. said it is important to encourage people to speak up when they see something wrong. In one study, only 54% of internists said they would speak up if their supervisor told them to do something they knew was not right, compared to 97% of airline pilots.
Pay attention to follow-up care for patients, especially following a hospitalization. Coordinate care with the hospital when a patient is discharged. "Health systems are paying more attention to follow-up care," Elizabeth Woodock, a practice management consultant in Atlanta told the publication. "We've gone from the days of telling the patient being discharged, 'Here's a piece of paper. Good luck.'"
Team-based primary care may lead to better postdischarge patient outcomes, according to a recent Canadian study.