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December 15, 2010

Ensuring Safe and Effective Use of Medication and Health Care: Perfecting the Dismount

Author Affiliations

Author Affiliations: Cecil G. Sheps Center for Health Services Research and Division of General Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill.

JAMA. 2010;304(23):2641-2642. doi:10.1001/jama.2010.1844

In gymnastics, the dismount may be more important than the rest of the routine: it is the final element judges recall when evaluating the athlete. In health care, we often ignore the dismount—the handoff of responsibility from the health care system to the patient. Tremendous intellectual and capital resources are allocated toward making diagnoses, developing therapies, and designing treatment plans, but relatively few resources are spent on the transfer of care to the patient. Physicians, nurses, health systems, health plans, and pharmaceutical companies frequently botch the dismount. As a result, countless numbers of people may be injured or inadequately treated.