Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Network Open, 7(12), e2450172. https://doi.org/10.1001/jamanetworkopen.2024.50172 Dr. Rafael Ortega et al.
Points
- Biased handoffs, particularly those involving blame-based bias, significantly reduced clinical information recall accuracy compared to neutral handoffs (77% vs. 93%, P = 0.005).
- Participants who identified bias in handoffs had lower recall accuracy (85%) compared to those who did not identify bias (93%, P = 0.01).
- Biased handoffs led to less favorable attitudes toward patients, with lower mean PASS scores (22.9 vs. 25.2 for neutral handoffs, P < 0.001).
- Positive attitudes toward patients were positively correlated with better clinical information recall (odds ratio 1.12, 95% CI, 1.02-1.22).
- The study emphasizes the need to standardize handoff procedures to eliminate biased language, reduce racial bias, and improve patient safety and care quality.
Summary
A survey study conducted across two U.S. academic medical centers assessed the impact of biased language in simulated verbal handoffs on clinical information recall and attitudes toward patients. The study included 169 participants, consisting of internal medicine, pediatrics, and internal medicine-pediatrics residents and senior medical students. Participants were randomized to receive handoffs that were either biased or neutral in language, with biased handoffs containing elements of stereotype, blame, or doubt. After each handoff, participants were asked to recall clinical information and report their attitudes toward patients using the Provider Attitudes Toward Sickle Cell Patients Scale (PASS).
The results indicated that participants who received biased handoffs, particularly those with blame-based bias, had significantly lower clinical information recall accuracy than neutral handoffs. Specifically, recall accuracy for blame-based handoffs was 77% versus 93% for neutral handoffs (P = 0.005). Additionally, participants who identified bias in the handoff had a recall accuracy of 85%, compared to 93% in those who did not identify bias (P = 0.01). Furthermore, participants who received biased handoffs had less favorable attitudes toward patients, with mean PASS scores of 22.9 for biased handoffs compared to 25.2 for neutral handoffs (P < 0.001). Positive attitudes toward patients were positively associated with clinical information recall, with an odds ratio of 1.12 (95% CI, 1.02-1.22).
This study highlights the detrimental effects of biased language in clinical handoffs. Biased language can lead to poorer patient care by reducing the accuracy of critical clinical information transfer and decreasing empathy. The findings underscore the importance of standardizing handoff procedures to reduce racial bias and improve patient safety.
Link to the article: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2828116
References Wesevich, A., Langan, E., Fridman, I., Patel-Nguyen, S., Peek, M. E., & Parente, V. (2024). Biased language in simulated handoffs and clinician recall and attitudes. JAMA Network Open, 7(12), e2450172. https://doi.org/10.1001/jamanetworkopen.2024.50172
