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Handoffs at teaching hospitals seen as harmful to patients

More than half of medical and surgical residents have seen harm related to patient handoffs, says a study in the October Joint Commission Journal on Quality and Patient Safety.

About 12% of the 161 Massachusetts General Hospital residents surveyed for the study said a handoff resulted in major harm such as worsening of the patient's clinical status, a longer hospital stay, disability or death. The handoff process often occurs in a loud, harried setting beset by frequent interruptions, making the communication of critical patient information difficult, the study said.

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Palliative care programs take hold in Calif. hospitals

A survey released in September found a sharp rise in the number of hospital-based palliative care programs in California, with more than 90% of such programs created since 2000. About 43% of hospitals offer some type of palliative care program, says a study of 325 hospitals by the California Healthcare Foundation, a nonprofit that advocates for improving care for underserved populations.

San Francisco and Sacramento lead the pack with about two-thirds of hospitals in those cities having palliative care programs. About half of Los Angeles and San Diego hospitals have them, but only a third of Orange County hospitals offer coordinated palliative care services. Nonprofit hospitals and those within health systems were most likely to have palliative care programs.

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Texas high court declines to address medical liability cap

The Texas Supreme Court in September denied an appeal by state physicians asking justices to affirm the constitutional validity of a $250,000 cap on noneconomic damages in medical liability cases. Texas voters passed the award limit as a constitutional amendment in 2003.

The Texas Medical Assn., Texas Hospital Assn. and Texas Alliance for Patient Access appealed to the high court in February in response to a negligence case claiming the cap violates patients' jury trial rights. The trial court did not decide the issue.

The organizations had hoped that the state Supreme Court would resolve the dispute before similar challenges filed across the state wind their way through the courts. Tort reform advocates attributed a marked improvement in access to care since the reform's passage, and they intend to preserve it, said Michael S. Hull, lead counsel in the case. He added that the groups plan to file another appeal with the high court.

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