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Volume XXV, No. 9

December 2011

The Independent Medical Business Newspaper

Handoff communication

Creating a new process to improve care By Sommer Alexander, MS, and Michael Aylward, MD


onsider the following two scenarios:

The physicians’ reflections on 2011’s top stories run the gamut from new medications and treatments for specific diseases to how new of 2011, technology and payment models are affecting their for 2012 practices. Some see sweeping changes ahead due to health care and payment reforms; others envision progress in improving patient care and reducing morbidity and mortality from chronic, relentless diseases. We thank all the physicians who participated in this feature for sharing their perspectives with our readers.

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Detriot Lakes, MN Permit No. 2655






s we approach the end of year, we’ll soon be seeing the inevitable end-of-the-year “Best of 2011” lists—from the frivolous to the proTop stories found. In health care, highpredictions impact medical news in 2011 ranged from foodborne illness to the aftermath of natural disasters; and from political concerns and new models of care to breakthrough drugs for various medical conditions. For a Minnesota perspective on the past year in medical news, we asked physicians to answer two questions for this feature: 1. What was the “big story” or major trend for your medical specialty/practice in 2011? 2. What predictions do you have for your medical specialty/practice in 2012?

• A 52-year-old woman with COPD comes to the emergency department (ED) with cough and fever. She is diagnosed with pneumonia, and ceftriaxone and azithromycin are ordered. The ED physician calls the inpatient physician. The ED nurse calls the inpatient nurse. The patient arrives on the floor, and it is not clear whether she ever received the antibiotics. The inpatient nurse pages the resident admitting for that night. The resident says, “I've never heard of that patient, are you sure she’s coming to us?” And so on. • The same patient comes into the ED, a diagnosis of pneumonia is made, and the patient is given antibiotics. The physicians and nurses who were caring for her in HANDOFF to page 22


Senior and long-term care Page 20

Minnesota Physician December 2011