Reduce the risks of patients falling between two stools

Patients travel across bridges when they move from the care of one professional to another. Communication between clinicians forms the structure of these handover bridges and is a known point of medico-legal risk. Dr Sarah Coope looks at the gaps in information, misunderstandings and assumptions that can increase the risk of errors, conflict and complaints.

We cannot have complete control over our patients’ illness and disease progression or the way they respond to interventions.

But we can take steps to ensure there is a strong bridge of communication to support effective continuity of care for the patient, give protection against adverse events and reduce medico-legal risk. 

Imagine you are between appointments in your busy private clinic on a Friday afternoon and your colleague rings you..

She asks you if you mind covering for her this weekend, as she needs to go and visit her elderly mother who has had a fall; she has performed a routine operation on a private inpatient earlier that day and says everything is fine. 

How do you respond? Most of us would agree to do this, knowing that these arrangements often need to be reciprocated. However, how strong is that bridge as the patient moves across to your care and responsibility, albeit temporarily? 

More questions

No doubt, you would usually ask more questions before ending the call. You would seek to find out more about the patient’s background, to assess whether there is any likely risk of complication and establish what the plan is for his discharge. 

You would likely check that your colleague has documented this conversation with you in the patient’s records for medico-legal reasons, but also so that ward staff know that you have agreed to be contacted if necessary. 

However, would you make a note yourself of the patient’s details, history and current status so that you have this information available to remind you, now that you have taken over responsibility?