More attention given to shift changes among medical staff can ensure greater patient safety in hospital emergency departments.
That’s one of the key assertions Robert L. Wears, MD, PhD, MS, made as he presented safety-related research during a Nov. 3 event in Gainesville called Lunch with a Scientist. The event was part of the five-day ScienceWriters annual conference, which was held on the University of Florida’s main campus.
Wears, a professor of emergency medicine at the UF College of Medicine – Jacksonville, discussed
papers he co-authored with fellow researchers on various aspects of patient safety in the emergency department. One of the studies centered on transitions in care among nurses and physicians.
The study — which documented ED dynamics at five hospitals with academic affiliation — maintains that efforts to improve handovers in those departments “have generally failed.”
“These failures may be due in part to the absence of a deep understanding of the multidimensional nature of transitions, resulting in one-size-fits-all interventions that do not support technical work,” the researchers wrote. “A better understanding of the nature of handovers in health care may prove to better interventions in the future.”
However, Wears told a group of science writers Nov. 3 that his findings reject some of the widespread negative beliefs about medical staff handovers. According to his research, handovers are well-structured and are “sources of rescue” because the oncoming staff member provides fresh eyes, a fresh mind and a second opinion regarding patient care.
“So maybe we should have more, not fewer, handoffs,” said Wears, who is regarded nationally as an expert in patient safety.
Wears also discussed other research that highlighted the use of electronic information boards versus traditional white boards; formal versus informal note-taking among staff; and the arrangement of patients in the ED.
He said medical centers need to be more proactive in identifying their organizational problems to help ensure greater patient safety. He hopes his research fosters more awareness.
“We know something unexpected will happen. We just don’t know the details of the unexpectedness,” said Wears, speaking on the nature of emergency care.
“Sometimes a hospital doesn’t want to know its problems because then it will have to invest in fixing those problems,” he added. “There’s been a steady decline in patient safety, and I think that’s a real problem.”
Thomas Ulrich, a senior science writer at Boston Children’s Hospital, was glad to have attended Wears’ presentation.
“I was struck by Dr. Wears’ emphasis on observation and context, how looking at why something happens in the ER can tell you what’s really working and what may not be in terms of patient safety,” Ulrich said.
Fellow Boston writer Stephanie Dutchen was intrigued by Wears’ talk about whiteboard use.
“I was especially interested in his descriptions of how and why ER staff continue to rely on whiteboards and personal index card systems for record keeping and patient status tracking despite the introduction of computer programs,” said Dutchen, who works in communications at Harvard Medical School.
“It was a fascinating lunch and I look forward to hearing about more discoveries from Dr. Wears' group in the future,” she said.
The 2013 ScienceWriters conference, which took place Nov. 1–5, was a joint meeting of the National Association of Science Writers and the Council for the Advancement of Science Writing. In addition to research presentations, it featured professional development workshops, networking opportunities and field trips — activities all intended to appeal to journalists and other writers who focus on health and science-related issues.
Part of the Lunch with a Scientist event was held inside UF’s Clinical and Translational Research Building, which opened earlier this year. Wears was one of 21 presenters at the event.
“I certainly liked it,” Wears said about the function. “The group was great. They asked good questions and were engaged the entire time. I’d definitely do this again.”