Handover

1. Handover

2. Outline • Objective of a Handover • Ground rules to shift work • Barriers to a good handover • Ways to make handover work

3. Objectives • Adequate and appropriate transfer of clinical information • Help provide continuity of care • Avoid errors and improve patient safety • Medical education role • Professional protection

4. Ground rules for shift-work • The team, rather than the individual, should be seen as the care provider • Different individuals providing care will be accepted as long as existing team knowledge is retained • Patients dislike having to answer the same questions over and over • Clear outline of outstanding tasks

5. Barriers to a good handover • People arriving late • More than one person speaking at once • Inattention • Interruptions (nursing/other) • Poor leadership • Failure to assign tasks/jobs to specific team members

6. Ways to make handover work • Start on time • Make sure all outgoing and all incoming team present • Handover sheet up to date, all patients and locations correct • Clear leadership (ideally consultant of the week at 2 of 3 daily handovers)

7. Handovers and education • Handover without senior input is a lost educational opportunity • Stimulate reflection on how team handing over have handled case • Discuss alternative approaches • Discuss rationale for investigations and management

8. Handovers should reduce stress and improve satisfaction • Should reduce uncertainty and stress for those starting shift • Should be an opportunity for positive feedback for those who have done well • A key time for team morale

9. Summary • Effective handovers • Transfer of high quality, adequate and appropriate clinical information between team members • Clarify responsibility • Improve patient safety • Assist medical education • Reduce stress • Boost team morale • Need effort and good leadership