Transitions in patient care do not occur without negative consequences. We have known for more than 20 years that a cross-covering physician dramatically increases the risk of preventable adverse events.¹ The 2003 implementation of duty hour restrictions increased the number of handoffs required for care of inpatients; these changes also led many to question whether duty hour restrictions were a benefit or detriment to patient safety, with both medicine and surgery residents indicating that patient harm commonly resulted from handoffs.² No place is there more potential for patient harm resulting from handoffs than the intensive care unit (ICU), owing to patients’ severity of illness and the resulting complexity of this patient population.

没有负面后果就不会发生患者护理的过渡。我们已经有20多年的历史了，跨学科的医师大大增加了可预防的不良事件的风险。¹ 2003年实施的工作时间限制增加了住院病人护理所需的交接数量；这些变化也导致许多人质疑工作时间限制是对患者安全还是对患者安全的危害，医学界和外科界人士都表明，移交通常会对患者造成伤害。²没有任何地方比重症监护病房（ICU）更有可能因移交而对患者造成伤害，这是由于患者的病情严重程度以及该患者群体的复杂性所致。