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Wed Dec 3 22:17:11 GMT 2008

From: rfsmithmd at comcast.net> Here's what I don't get: "...... Each time you hand off a patient there is a possibility of error." So the solution to this is to increase the number of hand offs.

-->  This is a recurrent issue for all specialties, I guess.
I don't think anyone is proposing making residents' hours more sensible in order to solve THIS problem. Trainee doctors in Europe, the UK and elsewhere have been banned from working schedules which are far less taxing than what American trainees are still doing nowadays, because there was evidence of declining performance with longer shifts and overwork. It is THIS they are trying to address.

Additionally, that "hand offs", as you call them, are done badly is not necessarily the fault of having them - perhaps it is because they are done badly!

For thousands of years we have been told the "fact" that hand offs are bad & dangerous for the patient. I don't believe this is so. BAD hand offs are bad. Good hand offs are safe. I have seen a number of ways in which hand offs may be done safely and this does not surprise me - after all, no-one seems to criticise the process of patients being referred to another specialty doctor - why is THAT not "dangerous"?

Once residents' hours are shortened to a decent level, more hand offs will happen, so it is vital to get the process itself to be safe, regardless of how often it happens. Luckily, this can be achieved, so there will be two positives...
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