The Identification of Factors Contributing to Negative Handover Experiences of Pre-Hospital Emergency Care Personnel in Johannesburg, South Africa

Abstract

Introduction The handover of a patient in the pre-hospital setting is different to other handover settings and therefore requires a different definition and description to that of other patient handover environments. Identifying those factors that affect the efficacy of handover could provide useful for formulating improvement strategies. Aim This research set out to describe the negative experiences of pre-hospital emergency care personnel handing over in the emergency centre in Johannesburg, South Africa, with a view to identifying potential areas for improvement. This paper reports on responses to an open-ended question that formed part of a purpose-designed, paper-based questionnaire that formed part of a mixed-methods study. Methods Data were collected from pre-hospital emergency care personnel within Johannesburg, South Africa. Responses from 140 participants were captured verbatim into Atlas.ti® for coding, analysis and interpretation using a qualitative descriptive methodology. Two themes were generated from a qualitative descriptive analysis of the data: communication barriers, and process barriers to emergency centre handover. These were confirmed by the categories and codes that made up these themes. Conclusion This study identifies some of the factors perceived by pre-hospital emergency care personnel to negatively affect emergency centre handover. It provides insights into how communication and process within the emergency centre have the potential to negatively impact emergency centre handover efficacy.

Experiences of emergency care providers conducting critical care transfers in Gauteng Province, South Africa

“…[1,2] This situation creates obvious concerns around patient safety, as it has been shown that not using a suitably qualified team for a CCT increases the risk of adverse events. [24] Such practices are not unique to the SA context, with some authors describing how a lack of CCT personnel may result in highacuity patients being transported by non-CCT crews simply to ensure that they arrive at the receiving facility. [1,2] The concern regarding this practice is that, despite their good intentions, the crew may be unable to render the required level of care and monitoring.…”

“…These circumstances are supported by other local studies that have shown that in-hospital staff generally have poor knowledge related to existing prehospital qualifications and scope of practice. [24,25] Consequently, hospitals commonly request CCTs for patients whose ongoing care and monitoring needs far exceed the scope and capability of the CCT team.…”

Descriptive literature review of human resource information systems (HRIS) adoption issues in the health sector, South Africa

“…Furthermore, 14.5 million is the estimated global health workforce shortage of which Africa is the most severely affected standing at an estimated 6.1 million by the year 2030 shows that Africa is still lagging in the use of HRIS to support the health workforce sustainability. Makkink, Stein and Bruijns (2021) emphasise that due to the shortage of specialised health personnel and lack of HRIS to identify the skilled workforce in mostly the low and medium income countries, people without medical qualifications are now practising as skilled physicians which is unprincipled and dangerous to the life and well-being of the society. Due to the lack of effective HRIS and increasing shortage of skilled workforce, the effect of the COVID-19 pandemic has negatively affected countries such as South Africa, China, Brazil, and India (BRICS NATIONS) (Reddy et al, 2021).…”

The Prehospital to Emergency Department Hand Over Model (PEDHOM): a conceptual model addressing content, process, and communication in prehospital to Emergency Department handover

“…These differences in clinician expectations have the potential to decrease the e cacy of interprofessional communication at handover. There is also recent evidence to suggest that there is a lack of interprofessional knowledge of roles between the prehospital and ED personnel [23,24].…”