1,883
views
0
recommends
+1 Recommend
0 collections
    8
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The ABC of handover: a qualitative study to develop a new tool for handover in the emergency department

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objectives

          This study identifies best practice for shift handover and introduces a new tool used to hand over clinical and operational issues at the end of a shift in the emergency department (ED).

          Methods

          Literature review, semi-structured interviews and observations of handover were used to develop a standardised process for handover. Participants were ED middle grades, consultants and senior nurses. Interviews were used to identify agreed best practice and derive a tool to classify the information into relevant sections.

          Results

          Interviews identified a variety of perceived current deficits in handover including a lack of standardised practice and structure. Participants provided examples of poor handover that were thought to have led to adverse events; these included delay in investigations and treatment for patients who were handed over with brief or inaccurate information. There was wide variation in the understanding of the meaning and purpose of shift handover, and differences were apparent according to the level of experience of the middle grades interviewed. The experts' responses were used to reach a unifying ‘best practice’ for the content of handover. This was then grouped under ABCDE headings to develop the ABC of handover tool.

          Conclusions

          A simple tool was developed to provide the basis for medical shift handover, which includes clinical and operational information necessary for efficiency and organisation of the next shift. The ABC of handover classifies shift information to be handed over under the ABCDE headings, which are easy to remember and highly relevant to emergency medicine.

          Related collections

          Most cited references12

          • Record: found
          • Abstract: found
          • Article: not found

          Medical errors involving trainees: a study of closed malpractice claims from 5 insurers.

          Despite wide recognition that the delivery of medical care by trainees involves special risks, information about the types and causes of medical errors involving trainees is limited. To describe the characteristics of and factors contributing to trainee errors, we analyzed malpractice claims in which trainees were judged to have played an important role in harmful errors. The claims were closed between 1984 and 2004, and the errors occurred between 1979 and 2001. Specialist physicians reviewed random samples of closed malpractice claim files at 5 liability insurers from 2002 to 2004 and determined whether injuries had occurred, and if so, whether they were due to error. We described the clinical circumstances and contributing factors associated with harmful errors involving trainees ("cases"). We also compared the characteristics of cases with their nontrainee counterparts and probed trainee errors attributed to teamwork problems and lack of technical competence or knowledge. Among 240 cases, errors in judgment (173 of 240 [72%]), teamwork breakdowns (167 of 240 [70%]), and lack of technical competence (139 of 240 [58%]) were the most prevalent contributing factors. Lack of supervision and handoff problems were most prevalent types of teamwork problems, and both were disproportionately more common among errors that involved trainees than those that did not (respectively, 54% vs 7% [P < .001] and 20% vs 12% [P = .009]). The most common task during which failures of technical competence occurred were diagnostic decision making and monitoring of the patient or situation. Trainee errors appeared more complex than nontrainee errors (mean of 3.8 contributing factors vs 2.5 [P < .001]). In addition to problems with handoffs, house staff are particularly vulnerable to medical errors owing to teamwork failures, especially lack of supervision. Graduate medical education reform should focus on strengthening these aspects of training.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Handoff strategies in settings with high consequences for failure: lessons for health care operations.

            To describe strategies employed during handoffs in four settings with high consequences for failure. of observational data for evidence of use of 21 handoff strategies. NASA Johnson Space Center in Texas, nuclear power generation plants in Canada, a railroad dispatch center in the United States, and an ambulance dispatch center in Toronto. Evidence of 21 handoff strategies from observations and interviews. Nineteen of 21 strategies were used in at least one domain, on at least an 'as needed' basis. An understanding of how handoffs are conducted in settings with high consequences for failure can jumpstart endeavors to modify handoffs to improve patient safety.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Transfers of patient care between house staff on internal medicine wards: a national survey.

              Transfer of responsibility for patient care between physicians is a key process in the care of hospitalized patients. Systems of transfer management and transfer frequency may affect clinical outcomes. To characterize the systems by which patient information is transferred ("signed out") between resident physicians in internal medicine residency programs and to determine the impact of recently enacted resident work-hour regulations on the frequency of transfers, we mailed a self-administered survey to chief residents at 324 accredited US internal medicine residency programs outside of New York State. The main outcome measures were sign-out practices, skills training, and transfer frequency. Surveys were returned from 202 programs (62%). Transfer systems varied among and within institutions: 55% did not consistently require both a written and an oral sign-out at transfers of care, 34% left sign-out to interns alone, and 59% had no means of informing nurses that a transfer had taken place. In addition, 60% of the programs did not provide any lectures or workshops on sign-out skills. After work-hour regulations were instituted, transfers of care for a hypothetical patient increased by a mean of 11% (from 7.0 to 7.8 transfers; P<.001) during a Monday-Friday hospitalization. A member of the primary team was in the hospital for 47% of the hospitalization. Although transfers of care are increasingly frequent, few internal medicine residency programs have comprehensive transfer of care systems in place, and most do not provide formal training in sign-out skills to all residents.
                Bookmark

                Author and article information

                Journal
                Emerg Med J
                Emerg Med J
                emj
                emermed
                Emergency Medicine Journal : EMJ
                BMJ Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1472-0205
                1472-0213
                December 2012
                3 January 2012
                : 29
                : 12
                : 941-946
                Affiliations
                [1 ]Emergency Department, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
                [2 ]Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College, London, UK
                Author notes
                [Correspondence to ] Dr Maisse Farhan, Emergency Department, First Floor QEQM, St Mary's Hospital, Praed Street, London W2 1NY, UK; maisse.farhan@ 123456imperial.nhs.uk
                Article
                emermed-2011-200199
                10.1136/emermed-2011-200199
                3512350
                22215174
                de427f8c-5156-4977-9439-f7c98362e842
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

                History
                : 20 November 2011
                Categories
                Original Articles
                1506
                Custom metadata
                unlocked

                Emergency medicine & Trauma
                communication,emergency department,emergency medicine,handover,healthcare quality,safety management

                Comments

                Comment on this article

                scite_
                42
                0
                36
                0
                Smart Citations
                42
                0
                36
                0
                Citing PublicationsSupportingMentioningContrasting
                View Citations

                See how this article has been cited at scite.ai

                scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

                Similar content372

                Cited by11

                Most referenced authors200