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Tue May 12 00:53:02 BST 2009

From: brombwi1 at memorialhealth.com
> Handoffs ARE dangerous and they do go up under a policy of more doctors working more frequent shifts. This is not an opinion, it's math and data

--> I know that this was not the main point of your e-mail and I generally am on "your side" of the debate, in that I also think reducing hours without "compensating" and changing culture (and stopping non-docs making these stupid changes) is the wrong way to go... BUT...

I think that to say that "handoffs are dangerous" is not really an accurate statement. Handoffs are INEVITABLE. POOR handoffs are dangerous. Handoffs at the wrong point/time in a patient's care are dangerous. But there are many conditions out there which will last longer than your shift no matter how long you stay in! So you WILL need to hand it to someone else, but you CAN do it well and safely at the correct time...

What happens when we have it "thrust upon us" that hours are reduced AND along with them so is the responsibility and the will to do what needs to be done, then by definition you get MORE handoffs done LESS well by the VERY inexperienced. But as has been stated here, just about every other aspect of care is worse and more "dangerous" under these circumstances. The only exception - the one thing which improves - is the number of hours a trainee spends "in"... And from here on I sing from your hymn sheet. But to point a finger at handoffs may well detract from our main point.

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"Handovers are dangerous" so I never go home or go on leave...