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