In Reply Abraham and colleagues raise important points regarding the challenge of developing metrics to evaluate the clinical consequences of incomplete handover communication,1 based on an impressive body of research focused on handover communication in the intensive care unit (ICU) setting.2,3 We developed our measurement approach with a specific goal to quantitatively measure how often on-call residents fail to handover on-call issues to the daytime physician team. This approach involved direct observation of morning handover communication to determine the proportion of clinically important issues (identified via real-time medical chart review) handed over by the on-call resident. Unfortunately, our approach did not allow us to determine whether these omissions actually resulted in patient harm or delays in care provision.
Kozij NK, Devlin MK, Wong BM. Metrics for Evaluating the Quality of Handovers—Reply. JAMA Intern Med. 2015;175(4):655. doi:10.1001/jamainternmed.2014.8024