Mr. S Changes Doctors
When medical residents graduate each June, they turn their outpatient clinic patients over to the care of another resident. This handoff due to residency graduation has been estimated to affect one million patients a year (1).
Transitioning patient care between residents is not without its dangers. Test results and screening opportunities can be missed, care can be delayed, and patients run an increased risk of requiring acute care (2,3). Patients report having trouble building rapport with their new doctors, as well as difficulty scheduling appointments and getting medication refills (4). In addition, patients often don’t return for care after their graduating doctor leaves, and risk being lost to follow-up (2).
This comic by MK Czerwiec (dannyd33.sg-host.com) depicts a common scenario for a clinic patient transferring care to a new resident with an unfortunate outcome, highlighting the need for quality improvement to enhance patient safety.
- Young JQ, Wachter RM. Academic year-end transfers of outpatients from outgoing to incoming residents: an unaddressed patient safety issue. JAMA. 2009;302(12):1327–9.
- Pincavage AT, Ratner S, Prochaska ML, Prochaska M, Oyler J, Davis AM, Arora VM. Outcomes for resident-identified high-risk patients and resident perspectives of year-end continuity clinic handoffs. J Gen Intern Med. 2012;27(11):1438–44.
- Caines LC, Brockmeyer DM, Tess AV, Kim H, Kriegel G, Bates CK. The revolving door of resident continuity practice. Identifying gaps in transitions of care. J Gen Intern Med. 2011;6(9):995–8.
- Pincavage AT, Lee W, Beiting KJ, Arora VM. What do patients think about year-end resident continuity clinic handoffs? A qualitative study. J Gen Intern Med. 2013;28(8):999–1007.