Handover

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

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

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

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

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)

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

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

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