[wighty]

> patient handoffs are dangerous.

I hate when this gets brought up, because it inherently implies that we can't improve them. Everyone talks about increases in handoffs causing increases in medical errors. I think handoffs have a long way to go, and we need to better utilize technology to help in this (ie make better EMRs).

The overworked doctor is just as bad IMO. I've been there on solo 28 hour calls going on my 11th admission. In the morning I'm next to useless and my handoff to that team was less than stellar.

[vacri]

I had a friend who was a QA process engineer at a regional hospital. He identified a significant source of errors - every morning there was a 'double-handoff' as the doctors handed off to nurses, who ended their shift and handed off to the next shift. The problem would be solved by moving hand-off time by a mere 15 minutes, but neither the doctors' group nor the nurses' group would budge on the matter.

I've heard a few other similar stories from him as well. Doctors have immense political power; if hospitals are grinding them to dust, it's because doctors as a group are letting them (the good old 'seniors don't care that juniors are getting crushed' problem). From my own limited experience working with them as a neuro tech, doctors will close ranks quickly against outside forces, but plenty will sell each other out within the profession. For every haggard ED doctor, there's a specialist somewhere making cushy deals with the administration.