Handover — Enabling Learning in Communication for Safety (HELiCS): a report on achievements at two hospital sites

Abstract

Clinical handover is an area of critical concern, because deficiencies in handover pose a patient safety risk. Redesign of handover must allow for input from frontline staff to ensure that designs fit into existing practices and settings. The HELiCS (Handover — Enabling Learning in Communication for Safety) tool uses a “video‐reflexive” technique: handover encounters are videotaped and played back to the practitioners involved for analysis and discussion. Using the video‐reflexive process, staff of an emergency department and an intensive care unit at two different tertiary hospitals redesigned their handover processes. The HELiCS study gave staff greater insight into previously unrecognised clinical and operational problems, enhanced coordination and efficiency of care, and strengthened junior–senior communication and teaching. Our study showed that reflexive and “bottom‐up” handover redesign can produce outcomes that harbour local fit, practitioner ownership and (to date) sustainability.

Creating safety by strengthening clinicians' capacity for reflexivity

“…Another project visualised the interactions in and among high-performance teams, and it became a means for team members to anticipate roadblocks and pro-actively address them 19 20. Yet other projects focused on clinical handover, enabling frontline clinicians to appreciate the risks and change opportunities present in existing ways of communicating 21 22. These projects confirmed that practitioners who decided to engage in video feedback were able and keen to cross over from personal reflection and technical adjustment into practice-wide, team-based and safety-conscious reflexivity 23…”

Clinical handover: critical communications

“…This ensures ownership of the process and a proper understanding of the local setting. User involvement is creatively addressed in the studies by https://doi.org/10.5694/j.1326-5377.2009.tb02620.x (on enhancing communication to improve patient safety) 10 and https://doi.org/10.5694/j.1326-5377.2009.tb02625.x (on the design and testing of a comprehensive handover form) 11 . The former allows clinicians to create their own handover solutions, while the latter involves clinicians in the implementation of an existing standardised tool.…”

An innovative approach to strengthening health professionals’ infection control and limiting hospital-acquired infection: video-reflexive ethnography

“…To date, this methodology has focused on multidisciplinary team communication,6 9 clinical handover,8 ward-round redesign10 11 and intensive care unit (ICU) spatial design 9. It is only very recently that video-reflexive ethnography has been deployed to strengthen practitioners’ and patients’ infection control 12…”