Residency

Computerized sign-out system may be one answer for limited duty hours

Residency Program Insider, July 20, 2010

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Researchers at the University of Washington (UW) in Seattle implemented an electronic rounding and sign-out system, called UW Cores. The system shortened rounding time, and the time spent recopying prerounds data, making it easier for residents to comply with duty hour standards. Researchers wanted to determine how these changes affected patient care, outcomes, and safety.

Surgical and medicine teams reported deviations in expected care during cross-coverage, medical errors, and institutionally reported adverse drug events (ADEs). The results were:

  • The mean number of resident-reported deviations from expected care per 1,000 patient days did not differ significantly between the control and UW Cores groups: 14.29 and 13.81, respectively
  • The mean number of reported incidents involving errors was 6.33 per 1,000 patient days for the control group and 5.61 per 1,000 patient-days for the UW Cores group
  • The odds ratio of a reported overnight medical error under the UW Cores system was 1.01. The odds ratio of an ADE while a resident is on an intervention team was 1.10.


According to researchers, managing information for sign-out and rounding with the UW Cores system improved continuity and enhanced resident efficiency without compromising systemic defenses against error or jeopardizing patient safety.

The study was published in Academic Medicine.
 



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