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32 QUALITY IMPROVEMENT & MEASUREMENT Physicians' choice: Best hospitals for treating key conditions By Megan Knowles I n a survey asking physicians to rank their hospital preferences for the treatment of several conditions, Rochester, Minn.- based Mayo Clinic was ranked highest for the treatment of six of the 10 conditions, and Houston-based MD Anderson Cancer Center took the top spot in treating all five cancer types, a Medscape survey found. Medscape asked over 11,000 physicians to rank their preferences for care and treatment for themselves or family, assuming there are no barriers, such as transportation or cost. Physicians ranked hospitals for the treatment of several serious conditions, including car- diac conditions, infectious diseases and five types of cancer. In all, the physicians named 33 hospitals. Here's how physicians ranked hospitals for cardiac conditions, infectious diseases and lung cancer: Cardiac conditions 1. Cleveland Clinic 2. Mayo Clinic Hospital, Methodist Campus (Rochester, Minn.) 3. Massachusetts General Hospital (Boston) 4. NewYork-Presbyterian/Columbia Univer- sity Medical Center (New York City) 5. Stanford (Calif.) Hospital 5. Brigham and Women's Hospital (Boston) 5. e Johns Hopkins Hospital (Baltimore) 8. Hospital of the University of Pennsylvania (Philadelphia) 8. Ronald Reagan UCLA Medical Center (Los Angeles) 8. Cedars-Sinai Medical Center (Los Angeles) Infectious diseases 1. Mayo Clinic Hospital, Methodist Campus (Rochester, Minn.) 2. e Johns Hopkins Hospital (Baltimore) 2. Massachusetts General Hospital (Boston) 4. Cleveland Clinic 4. Emory University Hospital (Atlanta) 6. Ronald Reagan UCLA Medical Center (Los Angeles) 7. NewYork-Presbyterian/Columbia Univer- sity Medical Center (New York City) 7. Hospital of the University of Pennsylvania (Philadelphia) Lung cancer 1. e University of Texas MD Anderson Cancer Center (Houston) 2. Memorial Sloan Kettering Cancer Center (New York City) 3. Mayo Clinic Hospital, Methodist Campus (Rochester, Minn.) 4. Cleveland Clinic 5. Massachusetts General Hospital (Boston) 5. Dana-Farber Cancer Institute (Boston) 7. e Johns Hopkins Hospital (Baltimore) 8. Ronald Reagan UCLA Medical Center (Los Angeles) 8. Hospital of the University of Pennsylvania (Philadelphia) 8. Duke University Hospital (Durham, N.C.) 8. Stanford (Calif.) Hospital 8. Brigham and Women's Hospital (Boston) n 4 ways to avoid communication errors during patient handoffs By Megan Knowles A s medical residents transfer patients from one team member to another, they can focus on several key strategies to avoid communication errors, according to a blog post on the AMA Wire. At an American Medical Association meeting, Joshua Davis, MD, a second-year emergency medicine resi- dent at Penn State Milton Hershey (Pa.) Medical Center, shared four best practices to make patient handoffs more effective: 1. Communicate each patient's unique needs. "Re- gardless of what specialty you practice, you are used to dealing with certain types of patients," Dr. Davis said. If cardiologists are handing off patients who are all 50-year-old men with chest pain, for example, they may start to blend together. "You want to make sure you hit the salient and important information that a provider needs," Dr. Davis said. "What is different and special about this patient?" 2. Be aware of handoff circumstances. "When I sign my patients off to a hospitalist or whatever specialist, I'm likely never taking care of that patient again," Dr. Davis said. "So, I may need to be a little more detailed, whereas someone who is signing out overnight may not need as much detail in terms of history and things. But they may focus more on the situational awareness." 3. Prioritize handoffs. Residents "must recognize that handoffs are [a] high-risk time," Dr. Davis said. Resi- dents can prepare themselves for handoffs by ensuring they have key information written down. "I find that having everything written down helps," Dr. Davis said, "If there's a lag between when I call to give someone a report and when I get a call back to give it, I may have done one thing or three things in that time." 4. Follow protocol. If a hospital does not have an established protocol for patient handoffs, residents can approach their leaders about having a standardized approach, Dr. Davis said. "It's also important to make sure that everybody rec- ognizes that approach and sticks to it. You can do your best during the handoff to model it and pay attention to [the protocol]." n