Arora V M, Johnson J K, Meltzer D O, Humphrey H J
V M Arora, University of Chicago, 5841 S. Maryland Ave., MC 2007, AMB W216, Chicago, IL 60637, USA.
Qual Saf Health Care. 2008 Feb;17(1):11-4. doi: 10.1136/qshc.2006.018952.
Once characterised by remarkable continuity of care by a familiar doctor, patient care today is delivered by multiple physicians with varying degrees of knowledge of the patient. Yet, few trainees learn the potential risks of these transitions and the strategies to improve patient care during handoffs. Little is known regarding the mechanisms by which handoffs affect patient care.
Building on theoretical constructs from the social sciences and illustrated with a case study of the implementation of a night float service for the inpatient general medicine services at the University of Chicago, a conceptual framework is proposed to describe how handoffs affect both patients and physicians.
Using this conceptual framework, recommendations are made for formal education based on the core competencies of communication and professionalism. Opportunities to educate trainees in acquiring these skills are described in the context of handoffs of patient care.
曾经，患者护理由熟悉的医生提供，具有显著的连续性，而如今则由多名对患者了解程度各异的医生负责。然而，很少有实习生了解这些交接过程中的潜在风险以及在交接班期间改善患者护理的策略。关于交接班影响患者护理的机制，人们知之甚少。
基于社会科学的理论构建，并以芝加哥大学住院普通内科服务实施夜间轮值服务的案例研究为例，提出了一个概念框架，以描述交接班如何影响患者和医生。
利用这个概念框架，基于沟通和专业精神的核心能力提出了正规教育的建议。在患者护理交接的背景下，描述了培训学员获得这些技能的机会。
