There is a growing body of literature on handover communication between prehospital and hospital receiving teams in civilian emergency care settings but little is known about how this differs from handover in the UK military medical services. This literature review shows that civilian handover is a complex process conducted in less-than-ideal circumstances, and it is affected by human behaviour and patient factors. There is a debate around standardisation including the use of the Mechanism, Injury or Illness, Signs, Treatment (MIST) mnemonic. There is limited understanding of how this mnemonic was used by the UK military, how it was developed to deal with specific patient characteristics or in the context of military operations in Afghanistan within which it evolved. Advancements in clinical practice made during conflict are ancillary to military objectives and should be supported by an evidence base before being transferred to civilian health care.
Background: There is a gap in the literature comparing communication during handover between military and NHS emergency care settings. Objectives: This study aimed to explore differences in handover communication in the NHS and the military, and to understand how paramedics manage the transition between settings. Design: This was a qualitative study for which 13 paramedics were interviewed. It focused on handover communication in NHS emergency care settings and Camp Bastion Hospital, Afghanistan. Methods: Interviews were conducted with regular and reservist paramedics serving in the Royal Air Force who had undertaken a deployment with the Medical Emergency Response Team. Semi-structured interviews were recorded, transcribed, coded and subjected to a thematic analysis. Results: Three principal themes were identified: differences between handover communication; standardisation; and the challenge of transition. Conclusion: Participants were most concerned about standardisation. Transition theory and resilience may account for the difficulties encountered when transitioning between different care settings.
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