Chapter 42. Information Transfer

Patient safety can be compromised by discontinuities in care. Studies suggest that discontinuity results from poor information transfer and faulty communication, which in turn may cause avoidable adverse events. Improving information transfer and communications among health care providers is an important patient safety practice and has been strongly recommended as a means to improve patient care. This chapter evaluates safety practices involving improvements of provider-toprovider information transfer. Practices for evaluation include transfer of information between inpatient and outpatient pharmacies (Subchapter 42.1), sign-out systems for medical housestaff (Subchapter 42.2), automatically generated electronic discharge summaries (Subchapter 42.3), and systems to improve patient notification of abnormal results (Subchapter 42.4).