In the not-too-distant past, the medical community wasn’t overly concerned about the quality of life of adults with cystic fibrosis (CF). It’s not that doctors were callous; the life expectancy for the disease was just so low that the vast majority of CF patients never lived to see adulthood. But improved understanding and management of the disease in the past 30 years has changed that.
On average patients with CF are living into their late 30s, up 85 percent from the early 1980s. Today, more than 40 percent of all CF patients in America are more than 18 years old.
National data suggest that up to 70 percent of sentinel events—the most serious errors in hospitals—stem at least in part from miscommunications. Communication problems are especially apt to occur during hospital shift changes, when a patient’s care is transferred to incoming doctors and nurses—known in health care as the “handoff.”
More than a year ago, a team led by Amy Starmer, MD, MPH, of the Division of General Pediatrics at Boston Children’s Hospital, developed and began testing a bundle of interventions to ensure that the hospital’s residents were thoroughly and accurately briefed on each patient’s medical history, status and treatment plan in a standardized way.
Through measures such as communications training, a mnemonic to help residents remember key information to pass on and a computerized handoff tool that integrated with the patient’s electronic medical record, they managed to move the needle: Medical errors fell by 40 percent—from 32 percent of admissions at baseline to 19 percent of admissions three months after the program started.