Electronic medical handover: towards safer medical care

Cheah, Lean-Peng; Amott, Debbie H; Pollard, James; Watters, David

doi:10.5694/j.1326-5377.2005.tb07086.x

Cited by 81 publications

(61 citation statements)

References 7 publications

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“…Efforts to improve handovers have looked to information technology (IT) solutions 35 38 41 56. These have mainly concentrated on the sign-out report.…”

Section: Resultsmentioning

confidence: 99%

Doctors' handovers in hospitals: a literature review

Raduma-Tomàs

Flin

Yule

et al. 2011

BMJ Quality & Safety

102

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“…Efforts to improve handovers have looked to information technology (IT) solutions 35 38 41 56. These have mainly concentrated on the sign-out report.…”

Section: Resultsmentioning

confidence: 99%

Doctors' handovers in hospitals: a literature review

Raduma-Tomàs

Flin

Yule

et al. 2011

BMJ Quality & Safety

102

View full text Add to dashboard Cite

show abstract

“…Within the medical model of handover, much of the research around information transfer follows recommendations for the development of standardised care planning and guidelines for clinical handover and surrounds the definition of a minimum dataset. The aim is to design a “simple, informative, time-saving and practical”31 way to assist clinicians, but this may require more applied, qualitative research to understand clinicians’ needs, perceptions and behaviours. Overall, there is a need for epidemiological research to explore and quantify outcomes.…”

Section: Informationmentioning

confidence: 99%

Improving measurement in clinical handover

Jeffcott

Evans

Cameron

et al. 2009

Quality and Safety in Health Care

128

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Background: Poor clinical handover creates discontinuities in care leading to patient harm. However, the field of handover research continues to lack standardised definitions and reliable measurement tools to identify factors that would lead to harm reduction and improved safety strategies. Objective: This paper introduces a conceptual framework to underpin a research agenda around the important patient safety topic of clinical handover. Methods: Five frameworks with potential application to clinical handover were identified in a consultation process with clinicians, researchers and policy makers. Results: The framework consists of three key handover elements-information, responsibility and/or accountability and system-in relation to three key measurement elements-policy, practice and evaluation. Using this framework an analysis of current ''gaps'' in the measurement of handover was completed. Conclusion: The paper argues that measurement will identify gaps in knowledge about handover practice and promote rigor in the design and evaluation of interventions to reduce patient harm.Poor clinical handover creates discontinuities in care leading to patient harm. It has been associated with inaccurate clinical assessment and diagnosis, delays in diagnosis, delays in test ordering, medication errors, inconsistent or incorrect results translation, duplication of tests, increased length of stay, increased in-hospital complications and decreased patient satisfaction. 1 Coronial cases may assist in elucidating the link to harm. 2 In spite of this, the handover research field continues to lack standardised definitions and reliable measurement tools to identify risk factors.Australia is leading international efforts to improve clinical handover. 3 4 It has been designated as the lead to develop and implement standardised solutions as part of the World Health Organization (WHO) Patient Safety Alliance 'High Fives' Initiative. This innovative initiative seeks to leverage cross-national learning among seven countries, using evidence-based protocols within five key patient safety areas. These include the prevention of 5 : c handover errors; c wrong site/wrong procedure/wrong person surgical errors; c continuity of medication errors; c high concentration drug errors; c promotion of effective hand hygiene practices. This paper focuses on clinical handover and introduces a conceptual framework to underpin a research agenda within this essential area. Although the development of metrics for handover will take concerted effort, we argue that measurement can help discover and fill gaps in our current knowledge of handover practice and promote rigor in the design and evaluation of interventions that aim to reduce patient harm in handover. WHAT IS CLINICAL HANDOVER?There are multiple conceptual models of clinical handover within healthcare. For this paper, we adopt the following definition:Clinical handover refers to the transfer of information and professional responsibility and accountability between individuals and teams, within the o...

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“…A number of factors have been found to contribute to ineffective handover processes, including (1) lack of formal policies and standard handover protocols regarding health-provider communications1 2; (2) a decrease in the time devoted to teaching and oversight in the workplace due to an increase in service workload3 and (3) attitudes and organisational culture, such as lack of responsibility to cross-cover patients, and a pervasive ‘culture of blame’ 3 4. Education and training in handover are considered effective means to address these issues 5.…”

Section: Introductionmentioning

confidence: 99%

Mapping and assessing clinical handover training interventions

et al. 2012

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Stoyanov, S., Boshuizen, H. P. A., Groene, O., Van der Klink, M., Kicken, W., Drachsler, H., & Barach, P. (2012). Mapping and assessing clinical handover training interventions. British Medical Journal Quality & Safety, 21, i50-i57. doi:10.1136/bmjqs-2012-001169Background: The literature reveals a patchwork of knowledge about the effectiveness of handover and transfer of care training interventions, their influence on handover practices, and on patient outcomes. We identified a range of training interventions, defined their content, and then proposed practical measures for improving the training effectiveness of handover practices. Methods: We applied the Group Concept Mapping approach to identify objectively the shared understanding of a group of experts about patient handover training interventions. We collected 105 declarative statements about handover training interventions from an exhaustive literature review and from structured expert interviews. The statements were then given to 21 healthcare and training design specialists to sort the statements on similarity in meaning, and rate them on their importance and feasibility. Results: We used multidimensional scaling and hierarchical cluster analysis to depict the following seven clusters related to various handover training issues: standardisation, communication, coordination of activities, clinical microsystem care, transfer and impact, training methods, and work-place learning. Conclusions: Ideas on handover training interventions, grouped in thematic clusters, and prioritised on importance and feasibility creates a repository of approaches. This allows health care institutions to design and test concrete solutions for improving formal training and work-place learning related to handovers, and addressing informal social learning at the organisational level, with the aim of increasing impact on handover practice and patient outcomes. Measures need to be taken to assure a continuum of handover training interventions from formal training through work-place learning through less formal social learning, and to embed this training in the design of the clinical microsystem

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Electronic medical handover: towards safer medical care

Cited by 81 publications

References 7 publications

Doctors' handovers in hospitals: a literature review

Doctors' handovers in hospitals: a literature review

Improving measurement in clinical handover

Mapping and assessing clinical handover training interventions

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