Document Type


Degree Name



Medical Informatics & Clinical Epidemiology


Medicine is faced with the unintended safety consequences of increased physician-to-physician handoffs of patients. Patient care had traditionally been provided by one physician who would follow a patient throughout his or her admission, but recent changes including restrictive resident duty hours and development of hospitalists have increased the frequency of transitioning patient care from physician to physician or team to team.

These transitions of care have been identified as a high-risk situation for increasing medical errors. This is compounded by the complexity of patients including polypharmacy, increasing acuity, changing code status, and multiple consultants. Studies have found that high-quality handoffs improve patient safety; accurate, written documentation plays a key role in these handoffs.

Once these high-quality data are available, they can be used for secondary purposes as well. The business environment of healthcare has placed a greater emphasis on analytic metrics. The oft-repeated phrase when discussing pediatric hospital medicine is “if you’ve seen one pediatric hospitalist program, you’ve only seen one pediatric hospitalist program.” This variation from program to program has made it difficult to compare patient outcomes as well as business measures such as physician compensation.

I propose that a purpose-designed database would be able to address physicians’ needs for efficiency and safety, administrators’ needs for data to be used for business intelligence, and the billing offices’ needs for legibility and efficiency.




School of Medicine



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