Background: End-of-service handoffs on inpatient general medicine services occur when there is a transfer of care to new providers, often at the end of a scheduled rotation. This is high-risk time for patients as increased in-hospital mortality has been observed around the time of end-of-service handoffs. The Society of Hospital Medicine recommends use of a [...]

Background: Multiple tools have been developed to improve the quality of signout from daytime clinicians to night covering clinicians. However, despite the frequency of holdover signout (new overnight admissions whose care is transferred to a new primary team), there are no studies or generally accepted best practices to ensure a high quality new admission handoff. [...]

Background: Transitions of care are known to be high-risk times in healthcare, largely due to communication errors between providers. Prior studies have shown a direct relationship between poor signout practices and adverse events. Verbal handoff tools, such as I-PASS, have been created in efforts to facilitate the signout process. An important aspect of the handoff [...]

Case Presentation: A 28-year-old woman with sickle cell disease and chronic pain who required inpatient care several times yearly presented with worsening nausea, emesis and uncontrolled pain to the emergency department (ED). Symptoms were typical of prior pain crises. The patient followed regularly with a hematologist undergoing monthly red blood cell exchange transfusions. In the [...]