Doctors' Handovers in an Acute Medical Assessment Unit: A Hierarchical Task Analysis

Abstract

Doctors' shift handovers have not been well documented, so handovers in an acute medical assessment unit (AMAU) were examined by conducting a hierarchical task analysis (HTA). To construct the HTA, activities doctors engaged in pre-handover, during handover, and post-handover were observed. Interviews and a focus group were also conducted to create the HTA. Findings showed that there are critical tasks that should be completed at each phase of the handover process. But these were sometimes omitted, especially in the pre-handover stage, resulting in extended or delayed handover meetings. Doctors believed that various safety nets were in place to catch any omitted information. Post-handover activities involved prioritizing tasks. However, doctors who had received handover believed that their period of responsibility and accountability for transferred patients was likely to be too short, and therefore expressed that prioritizing tasks for every patient was inefficient. Future research should examine handovers in the context of organizational resilience, and include other clinical staff that influence the information provided at handover.

Clinical shift handoffs in Singapore: A three-phase prospective

“…A handoff can be considered as a three-phase process, consisting of a pre-handoff phase, a handoff communication phase, and a post-handoff phase (Alvarado et al, 2006;Kerr, 2002;Raduma-Tomà s, Flin, Yule, & Close, 2010). The main objective of the pre-handoff phase is to ensure that the off-going party is ready to give a handoff to the on-coming party.…”

Improving shift handovers between medical residents : the effect of information access cost, metacognition and media affordances

“…Clinical handovers can be conceptualized as a three-phase process, namely prehandover, handover communication, and post-handover (Kerr, 2002;Raduma-Tomàs et al, 2010). Since accurate and adequate handover preparation and communication are the prerequisites to ensure proper post-handover performance, this research focused on the first two phases, aiming to propose a suitable framework for modelling the factors influencing the performance of pre-handover and handover communication.…”

“…A handover can be conceptualized as a three-phase process, consisting of prehandover, handover communication, and post-handover (Kerr, 2002;Raduma-Tomàs, Flin, Yule, & Close, 2010). The main objective of the pre-handover phase is to ensure that an outgoing professional is ready to transfer patients to an incoming professional.…”