Patient Care Management for Physicians: Reducing Handoffs in the ED

The Emergency Department (ED) is an environment prone to high error rates with severe consequences. Prior studies report that miscommunication contributes to 80% of the serious medical errors. Handoffs, transfer of patient care from one physician to another, are a common occurrence and predisposed to errors as a result of interruptions and high workload. Moreover, the Institute of Medicine reported that a majority of treatment delays are a result of communication errors associated with shift change. A simulation model was developed to test various physician to patient assignment policies to minimize the number of handoffs and reduce the workload at the end of a shift. Using a policy that restricts a physician from receiving high acuity patients in the last two hours of the shift, as well as limits the maximum number of patients per physician to five, the number of handoffs can be reduced by as much as 22%.