Evidence map›Paper›PMID 26958198›Full record

ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium2015

Uncertainty, Case Complexity and the Content of Verbal Handoffs at the Emergency Department.

Jan Horsky, Edward H Suh, Osman Sayan, Vimla Patel

Abstract read
In one paragraph

Article in AMIA ... Annual Symposium proceedings. AMIA Symposium, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Jan HorskyBrigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Edward H SuhNew York-Presbyterian Hospital, NY; Columbia University Medical Center, NY.
Osman SayanNew York-Presbyterian Hospital, NY; Columbia University Medical Center, NY.
Vimla PatelNew York Academy of Medicine, NY.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Handoffs are known to increase the risk of medical error and adverse events. Few electronic tools can support this process effectively, however. Our objective was to describe the relationship between clinical complexity, diagnostic uncertainty, fit with illness script and the content of case presentations by physicians. We observed the handoff of care for150 patients during eleven shift changes at a large urban emergency department (ED). Results indicate that as uncertainty about diagnosis and perceived illness script increased, more descriptive detail was conveyed to the incoming physicians. Physicians were concerned primarily with creating a shared mental model of a patient's clinical state and with describing the expected path to disposition rather than simply passing on data and findings. Electronic tools for ED handoffs should allow adjustment of structure and content to capture complexity and uncertainty appropriately without requiring extra effort for more routine cases that better fit to more standard narratives.

Indexed as

Patient HandoffVerbal BehaviorDecision MakingDiagnosisEmergency Service, HospitalHumansOrganizational Case StudiesUncertainty

Identifiers

PMID26958198
PMCPMC4765702

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.