Faculty mentor/PI email address
jim010@aol.com
Is your research Teaching and Learning based?
1
Keywords
Emergency Department; Hospital Medicine; Clinical Handoff; Patient Safety; Communication; Complex Adaptive Systems; Transitions of Care
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Background
Transitions from the Emergency Department (ED) to hospital medicine represent a high-stakes clinical handoff across systems. While often experienced as challenging, these interactions are better understood as occurring between services operating under different cognitive loads, operational priorities, and time horizons. Reframing the ED–hospitalist admission as a structured handoff aligns this process with broader patient safety efforts.
Objective
To characterize the ED–hospitalist admission as a cross-system clinical handoff and to identify practical strategies that enhance safety, clarity, and alignment during this transition.
Methods
Conceptual analysis informed by clinical experience, systems theory, and teaching observations. Key domains of potential misalignment were identified and mapped to targeted communication and system-level interventions.
Results
Six domains of potential misalignment in admission handoffs were identified:
Cognitive load differences
Operational priority differences
Protocol visibility gaps
Loss of visual clinical context
Relational familiarity gaps
Temporal mismatch
These domains represent predictable features of interacting clinical systems. Interventions focused on restoring shared context—including trajectory framing, communication of real-time clinical appearance, protocol clarity, explicit signaling of urgency, and relational familiarity—enhance the quality of handoffs.
Conclusion
The ED–hospitalist admission is best understood as a handoff of both patient and anticipated clinical trajectory. Enhancing shared understanding across systems improves the safety, efficiency, and reliability of care transitions.
Disciplines
Emergency Medicine | Medicine and Health Sciences | Quality Improvement
Included in
Reframing the ED–Hospitalist Admission as a Clinical Handoff: The ED to Hospital Admission as a Cross-System Handoff in a Complex Adaptive Clinical Environment. The Case for Systems Approaches to Enhance Safe and Effective Transitions Across A True System Interface
Background
Transitions from the Emergency Department (ED) to hospital medicine represent a high-stakes clinical handoff across systems. While often experienced as challenging, these interactions are better understood as occurring between services operating under different cognitive loads, operational priorities, and time horizons. Reframing the ED–hospitalist admission as a structured handoff aligns this process with broader patient safety efforts.
Objective
To characterize the ED–hospitalist admission as a cross-system clinical handoff and to identify practical strategies that enhance safety, clarity, and alignment during this transition.
Methods
Conceptual analysis informed by clinical experience, systems theory, and teaching observations. Key domains of potential misalignment were identified and mapped to targeted communication and system-level interventions.
Results
Six domains of potential misalignment in admission handoffs were identified:
Cognitive load differences
Operational priority differences
Protocol visibility gaps
Loss of visual clinical context
Relational familiarity gaps
Temporal mismatch
These domains represent predictable features of interacting clinical systems. Interventions focused on restoring shared context—including trajectory framing, communication of real-time clinical appearance, protocol clarity, explicit signaling of urgency, and relational familiarity—enhance the quality of handoffs.
Conclusion
The ED–hospitalist admission is best understood as a handoff of both patient and anticipated clinical trajectory. Enhancing shared understanding across systems improves the safety, efficiency, and reliability of care transitions.