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I haven’t read that literature very closely, but will say that I have seen lots of handoffs, and they generally involve someone who has been working 12+ hours, very often 24+ hours, who needs to hand off 10s of patients to 3+ people, all of whom have things to do and can be hard to schedule around, before they can go home.

It is not at all surprising to me that these kind of hand offs result in things being missed, and equally obvious that decreasing the patients per provider and increasing hand off window hours would at least reduce some of those errors, if not outright improve them. Bonus points for putting the peak of handoffs into late morning hours, where much more of the decision making is completed.

Of course, the only way to do that is to either:

1) drag hours out longer, which I think lots of MDs would be fine with if they weren’t expected to turn around and do it again in 18-36 hours, requiring increased staffing

Or 2) increase staffing all around and just maintain more reasonable ratios