New Research Reveals Higher Mortality Rates Linked To End-Of-Rotation Transitions

End of rotation handoffs mortality

If you work in the medical field – and perhaps even for those who don’t – it’s very possible that you know of a doctor who has made a life-ending error. It’s honestly not that uncommon. You see, doctors are humans, and they make mistakes just like rest of us. The only difference, perhaps, is that in this field, miscues tend to have harsher consequences than for professionals in other industries.

This is one of the reasons Joshua Denson, MD, and current fellow at the University of Colorado Anschutz Medical Campus in Aurora, is raising awareness about the heightened risk of patient mortality rates during the transition period from when interns and residents finish their rotations and incoming rotators assume the role, according to Medpage Today.

At the annual meeting of the American Thoracic Society, Denson and his team of researchers reported the findings of their large ongoing study that has been in cognition since 2008. At the press conference, Denson said:

“After analyzing 230,701 hospital admissions, we estimate end-of-rotation house staff transitions were responsible for 718 additional deaths in the hospital.”

The team of researchers analyzed data from adult patients who were discharged from hospitals from July 1, 2008, to June 30, 2014. The patients who were analyzed were discharged from 10 different university-affiliated Veterans Affairs medical centers.

The study defined a “transition patient” as a person discharged within 7 days following the end of rotations staff transition that occurs at the end of each month. Denson said that depending on the type of rotation and the level of experience of an incoming team, that the mortality rates could spike nearly 20 percent.

The study also showed that the the increase of mortality rates was not significant when residents-only transitioned off their rotations. Denson said:

“Adjusted hospital mortality risk was strongest for patients exposed to only intern transition, suggesting that level of training may be a contributing factor.”

Denson has had an invested interest in critical care outcomes and health services research since he began his medical career at the Tulane University School of Medicine. His research and efforts have reached many within the medical community, but this issue is still widely prevalent among many medical institutions.

There are currently some hospitals who have employed a “warm handoff” procedure, which is where the outgoing resident or intern spends an extra day with the incoming team, but while these procedures are a step in the right direction, many hospital administrators are completely overlooking the statistics. Denson said:

“These findings raise concern about the adequacy and quality of end-of-rotation handoffs and point to the need for systematic attention to this often overlooked critical transition in care.”

Riley Schatzle
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