Safe use of symbols in handover documentation for medical teams

Abstract

This is the unspecified version of the paper.This version of the publication may differ from the final published version. Permanent repository link AbstractConcern has been reported about the safe use of medical abbreviations in documents such as handover sheets and medical notes, especially when information is being communicated between staff of different specialties (BBC, 2008, Sheppard et al, 2008. This paper describes a study to investigate whether the use of symbols in handover documentation that is shared within and between multidisciplinary teams (MDTs) has similar safety implications.We asked 19 healthcare professionals from a range of specialties to identify 45 different combinations of 38 individual symbols. The symbols and combinations of symbols were extracted from 102 handover sheets taken from 6 different healthcare contexts in 4 London hospitals. 3 symbols proposed in Microsoft's Common User Interface guidelines for alert symbols were also included. Results reveal that while some symbols are well-understood, many others are either ambiguous or unknown.These results have implications for the safe use of symbols in medical documents, including paper and electronic handover documents and Electronic Patient Records (EPRs), especially where teams comprise individuals from different professional backgrounds, i.e. MDTs. We offer initial suggestions for standardization and further research.

Shared decision making needs a communication record

“…While effective teamwork is considered one of the ways to improve communication and reduce the number of errors, the majority of communication breakdowns occur in verbal communication when patients are being transferred among clinical staff [27]: a practice recognised as a frequent activity at meetings [21], a regular outcome of an MDT discussion, and an acknowledged challenge for researchers in this area [10,27]. Moreover, inadequate medical record-keeping is known to threaten health care quality especially with respect to coordination and continuity of care, decision-making capacity and accountability [32].…”

Cognitive Maps to Visualise Clinical Cases in Handovers

“…This seems not to be the case in handovers. Symbols such as "∆", "Ø" were shown to have no unique meaning across handover documents [38]. The authors concluded that an unambiguous set of symbols needed to be defined.…”

Medical team meetings: utilising technology to enhance communication, collaboration and decision-making

“…Although the issue of capturing information during discussion is not discussed directly, several of the papers in this issue refer to the importance of records from team meetings, namely Frykholm and Groth (2011), Meum and Ellingsen (2011), Napolitano et al (2011), without stating the form that those records might take. Galliers et al (2011) prompt consideration of the potential for symbols to be considered in the development of electronic records. That is, the rather vexed issue of how much standardisation is appropriate is raised.…”