Display Settings:

Format

Send to:

Choose Destination
We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Ann Intern Med. 2005 Mar 1;142(5):352-8.

Fumbled handoffs: one dropped ball after another.

Author information

  • Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts 02120, USA. tgandhi@partners.org

Abstract

Missed follow-up of abnormal test results and resultant delays in diagnosis is a safety issue that is gaining increasing attention. Despite increases in the numbers and types of available diagnostic tests, current systems in health care do not reliably ensure that test results are received and acted upon by ordering physicians. This article examines the case of a patient whose diagnosis of tuberculosis was substantially delayed because of systems problems, including poor continuity (with multiple-provider involvement), lack of communication of test results and other clinical information, and several handoffs. Strategies to ensure adequate communication of critical information and follow-up of test results are discussed, such as explicit criteria for communication of abnormal results, test-tracking systems for ordering providers, and use of information technologies.

Comment in

  • Fumbled handoffs. [Ann Intern Med. 2005]
  • Fumbled handoffs. [Ann Intern Med. 2005]
PMID:
15738454
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Silverchair Information Systems
    Write to the Help Desk