In-hospital fellow coverage reduces communication errors in the surgical intensive care unit.

Publication/Presentation Date

6-1-2014

Abstract

BACKGROUND: Staff coverage strategies of intensive care units (ICUs) impact clinical outcomes. High-intensity staff coverage strategies are associated with lower morbidity and mortality. Accessible clinical expertise, team work, and effective communication have all been attributed to the success of this coverage strategy. We evaluate the impact of in-hospital fellow coverage (IHFC) on improving communication of cardiorespiratory events.

METHODS: A prospective observational study performed in an academic tertiary care center with high-intensity staff coverage. The main outcome measure was resident to fellow communication of cardiorespiratory events during IHFC vs home coverage (HC) periods.

RESULTS: Three hundred twelve cardiorespiratory events were collected in 114 surgical ICU patients in 134 study days. Complete data were available for 306 events. One hundred three communication errors occurred. IHFC was associated with significantly better communication of events compared to HC (P< .0001). Residents communicated 89% of events during IHFC vs 51% of events during HC (P< .001). Communication patterns of junior and midlevel residents were similar. Midlevel residents communicated 68% of all on-call events (87% IHFC vs 50% HC, P< .001). Junior residents communicated 66% of events (94% IHFC vs 52% HC, P< .001). Communication errors were lower in all ICUs during IHFC (P< .001).

CONCLUSIONS: IHFC reduced communication errors.

Volume

29

Issue

3

First Page

445

Last Page

449

ISSN

1557-8615

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

24529985

Department(s)

Administration and Leadership

Document Type

Article

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