Cognitive support for a better handoff: does it improve the quality of medical communication at shift change in an emergency department?

From the European Journal of Emergency Medicine, with an abstract published in PubMed:

AIM:

To improve the communication during shift handover in an emergency department.

METHODS:

We observed the handover process and analysed the discourse between physicians at shift change first, and then we created two cognitive tools and tested their clinical impact on the field. We used different measures to evaluate this impact on the health care process including the frequency and type of information content communicated between physicians, duration of the handoff, physician self-evaluation of the quality of the handoff and a posthandover study of patient handling.

RESULTS:

Our results showed that the patient’s medical history, significant test results, recommendations (treatment plan) and patient follow-up were communicated to a greater extent when the tools are used. We also found that physicians spent more time at the bedside and less time consulting medical records using these tools.

CONCLUSION:

The present study showed how in-depth observations and analyses of real work processes can be used to better support the quality of patient care.

Emergency Crews Create Makeshift Surgery Unit to Amputate Man’s Leg

From JEMS:

Emergency crews say they created a makeshift surgery unit in a Salt Lake-area train yard to amputate the leg of a 19-year-old trapped under cargo.

South Salt Lake Fire Chief Ron Morris says the man may have been pinned for eight hours before a railroad worker found him about 1 p.m. Thursday.

Morris tells KSL (http://bit.ly/PFFWjM ) the man and his dog apparently hopped a freight train in Denver. He was found in an open train car carrying sheets of steel up to 15 feet long, and was apparently trapped when the cargo shifted.

EMT okay after tipping ambulance

From the Silver Pinyon Journal:

Trouble began for the ambulance driver after she crossed into Oregon and had to negotiate a tight turn. The driver overcorrected to the left and crossed the southbound lanes before bringing the ambulance to a stop, Maher said.

However, the ambulance stopped in soft dirt and as it settled the vehicle slowly tipped over and down an embankment – landing on the driver’s side.