‘Suboptimal’ communication during interhospital transfer leads to medical errors
Click Here to Manage Email Alerts
The quality of information about patients who were transferred from one hospital to another was often “suboptimal” and affected patient care, according to researchers.
They presented their findings at the virtual meeting of the Society of Hospital Medicine.
“As we know, interhospital transfer — which is the transfer of patients from one hospital to another — involves discontinuity of care that can lead to errors in communication as well as gaps in information exchange,” Stephanie Mueller, MD, MPH, SFHM, an associate physician at Brigham and Women’s Hospital and Harvard Medical School, said during the presentation. “The goals of this study were to quantify the frequency and type of clinician-reported failures and communication, as well as the frequency and type of medical errors attributable to those errors in communication.”
Mueller and colleagues conducted a prospective cohort study that surveyed 461 clinicians who cared for patients who were transferred from another hospital to the general medicine, cardiology, oncology or intensive care department at Brigham and Women’s Hospital between August 2020 and October 2020. Admitting clinicians completed surveys within 48 hours of a patient’s admission after interhospital transfer. Among the respondents, 208 worked in the cardiology department, 53 in general medicine, 130 in oncology and 70 in the ICU. The study’s outcomes were the reported quality of care and reported medical errors that could be attributed to communication or information exchange failures.
The researchers reported that information quality issues were “common” — 31% of respondents indicated that the quality of information was “poor” or “fair,” and 35% reported that important clinical information was missing.
“These seem to be more frequently reported among cardiology and oncology service transfers, which are the services that receive the highest volume of patients,” Mueller said.
Because of the lack of information, 22% of clinicians said they were uncertain about management decisions; 7% reported delays in tests, procedures, medications, fluids or other therapy; and 4% reported unnecessary tests or procedures.
“In summary, we found that suboptimal communication and information exchange during interhospital transfer is common and that this contributes to a sizeable frequency of medical errors, most frequently with patients receiving delays in care or unnecessary testing,” Mueller said. “Our next steps for this research project include designing and implementing an improved accept note documentation process to try to address these deficiencies in information exchange and communication during interhospital transfer and to measure the impact of this intervention on patient outcomes.”