A system for "computerized rounding" and handover of patient responsibility—also called "sign-out"—developed at the University of Washington may help ease the challenges of complying with medical resident 80-hour work limits.
The Web-based system the university developed, called UW Cores, was found to reduce the time residents at two Seattle hospitals spent managing patient information and generating sign-out materials by 30 to 45 minutes a day "without weakening systematic defenses against error or jeopardizing patient safety," according to a report published in Academic Medicine.
UW School of Medicine researchers tracked 14 resident teams at Harborview Medical Center and UW Medical Center (four medicine and three surgery teams at each facility) for 14 weeks, with half of the teams using the UW Cores system and half—acting as a control group—using written lists or computerized spreadsheets for sign-out. After seven weeks, the teams switched to the other information-management method.
To account for differences in patient load, the value measured was "overnight incidents per 1,000 patient days." The control group recorded 14.29 incidents of "deviations in expected care," 6.33 medical-error incidents and 23 total incidents in which a medication error reached a patient. In contrast, among teams using the computerized system, there were 13.81 incidents of deviations in care; 5.61 medical-error incidents; and 20 total incidents in which a medication error reached a patient.
The system, which provides "a standardized report for sign-out that includes resident-entered notes about patient-care tasks and plans," could help give residents more time to spend on educational and direct patient-care activities, the report concluded.