Clinical handover: critical communications

Jorm, Christine; White, Sarah J.; Kaneen, Tamsin

doi:10.5694/j.1326-5377.2009.tb02613.x

Cited by 44 publications

(53 citation statements)

References 24 publications

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“…Both the iSOBAR and the HAND ME AN ISOBAR (R referred to responsibility and risk management) reflect adaptations of a concept of structured content and reflect the concept of ‘flexible standardisation’ of the SBAR structure, that is, ‘allowing for customisation to ensure that it meets the needs of the local clinical context’ . For HAND ME AN ISOBAR, it is noted that four letters within the 14 reflect SBAR, whereas 10 do not.…”

Section: Discussionmentioning

confidence: 99%

Exploring the structure and organization of information within nursing clinical handovers

Johnson

Jefferies

Nicholls

2012

Int J of Nursing Practice

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Clinical handover is the primary source of patient information for nurses; however, inadequate information transfer compromises patient safety. We investigated the content and organization of information conveyed at 81 handovers. A structure that captures and presents the information transferred at handover emerged: identification of the patient and clinical risks, clinical history/presentation, clinical status, care plan and outcomes/goals of care (ICCCO). This approach covers essential information while allowing for prioritization of information when required. Further research into the impact of ICCCO on patient safety is in progress.

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Section: Discussionmentioning

confidence: 99%

Exploring the structure and organization of information within nursing clinical handovers

Johnson

Jefferies

Nicholls

2012

Int J of Nursing Practice

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“…With increasing focus on safe working hours, demand for part-time work and the move towards multidisciplinary patient care, handover is occurring more frequently 1 2. A recent Australian study estimated that patients see an average of 6–10 doctors per admission 3. However, current handover practices are criticised as being highly variable, unstructured, and error-prone 4.…”

Section: Introductionmentioning

confidence: 99%

Using the ISBAR handover tool in junior medical officer handover: a study in an Australian tertiary hospital

Thompson

Collett

Langbart

et al. 2011

Postgraduate Medical Journal

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Background Despite being essential to patient care, current clinical handover practices are inconsistent and error prone. Efforts to improve handover have attracted attention recently, with the ISBAR tool increasingly utilised as a format for structured handover communication. However, ISBAR has not been validated in a junior medical officer setting. Objective To assess the effect of the ISBAR handover tool on junior medical officer (JMO) handover communication in an Australian hospital. Methods JMOs who participated in after-hours handover during an 11 week clinical term from June to August 2009 were recruited. After-hours handover was audiotaped, and JMOs completed a survey to assess current handover perception and practice. JMOs then participated in a 1 h education session on handover and use of the ISBAR handover tool, and were encouraged to handover using this method. Following the education session, participants were surveyed to measure perceived changes in handover with use of ISBAR, and handover was again audiotaped to assess differences in information transfer and duration. Results Following the introduction of ISBAR, 25/36 (71%) of JMOs felt there was an overall improvement in handover communication. Specifically, they perceived improvement in the structure and consistency of handover, they felt more confident receiving handover, and they believed patient care and safety were improved. Audio-tape data demonstrated increased transfer of key clinical information during handover with no significant effect on handover duration. Conclusions Use of the ISBAR tool improves JMO perception of handover communication in a time neutral fashion. Consideration should be given to the introduction of ISBAR in all JMO handover settings.

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“…[18][19][20][21][22] Problems with this process have been associated with morbidity and mortality. [23][24][25][26][27] Inadequate handover has also been associated with problems with lack of coordinated team work (eg, duplication of tests). 26 28 29 Primary maternity care in Australia is undertaken by midwives, and doctors, including general practitioner (GP) obstetricians, obstetricians and obstetric trainee doctors under supervision.…”

Section: Introductionmentioning

confidence: 99%

Transferring responsibility and accountability in maternity care: clinicians defining their boundaries of practice in relation to clinical handover

Chin¹,

Warren

Kornman

et al. 2012

BMJ Open

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ObjectiveThis exploratory study reports on maternity clinicians’ perceptions of transfer of their responsibility and accountability for patients in relation to clinical handover with particular focus transfers of care in birth suite.DesignA qualitative study of semistructured interviews and focus groups of maternity clinicians was undertaken in 2007. De-indentified data were transcribed and coded using the constant comparative method. Multiple themes emerged but only those related to responsibility and accountability are reported in this paper.SettingOne tertiary Australian maternity hospital.ParticipantsMaternity care midwives, nurses (neonatal, mental health, bed managers) and doctors (obstetric, neontatology, anaesthetics, internal medicine, psychiatry).Primary outcome measuresPrimary outcome measures were the perceptions of clinicians of maternity clinical handover.ResultsThe majority of participants did not automatically connect maternity handover with the transfer of responsibility and accountability. Once introduced to this concept, they agreed that it was one of the roles of clinical handover. They spoke of complete transfer, shared and ongoing responsibility and accountability. When clinicians had direct involvement or extensive clinical knowledge of the patient, blurring of transition of responsibility and accountability sometimes occurred. A lack of ‘ownership’ of a patient and their problems were seen to result in confusion about who was to address the clinical issues of the patient. Personal choice of ongoing responsibility and accountability past the handover communication were described. This enabled the off-going person to rectify an inadequate handover or assist in an emergency when duty clinicians were unavailable.ConclusionsThere is a clear lack of consensus about the transition of responsibility and accountability—this should be explicit at the handover. It is important that on each shift and new workplace environment clinicians agree upon primary role definitions, responsibilities and accountabilities for patients. To provide system resilience, secondary responsibilities may be allocated as required.

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Clinical handover: critical communications

Cited by 44 publications

References 24 publications

Exploring the structure and organization of information within nursing clinical handovers

Exploring the structure and organization of information within nursing clinical handovers

Using the ISBAR handover tool in junior medical officer handover: a study in an Australian tertiary hospital

Transferring responsibility and accountability in maternity care: clinicians defining their boundaries of practice in relation to clinical handover

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