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Handovers: The ‘Hidden Threat’ to Patient Safety

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Abstract

Handover is the process of transfer of clinical patient information between doctors ending their shift and those starting their shift and taking responsibility for patient care. Reduction in working hours had resulted in increased shifts and numbers of handovers thereby risking continuity of care. Research on handover is limited yet ever expanding. Teaching handover is still not a part of the undergraduate curriculum. Handover remains ill defined, and a validated assessment tool is elusive. While there are several drawbacks, we continue to make advances in improving the quality of handover. Teaching programs and assessment tools are being developed. Moves are being made to standardise handover, and IT systems continue to be advanced in order to better support an effective handover.

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References

  1. Philibert I, Friedmann P, Williams WT. ACGME Work Group on Resident Duty Hours. Accreditation Council for Graduate Medical Education: new requirements for resident duty hours. JAMA. 2002;288:1112–4.

    Article  PubMed  Google Scholar 

  2. Fitzgerald JEF, Caesar BC. The European working time directive: a practical review for surgical trainees. Int J Surg. 2012;10:399–403.

    Article  CAS  PubMed  Google Scholar 

  3. Whitt N, Harvey R, McLeod G, Child S. How many health professionals does a patient see during an average hospital stay? N Z Med J. 2007;120:U2517.

    PubMed  Google Scholar 

  4. Vidyarthi AR, Arora V, Schnipper JL, Wall SD, Wachter RM. Managing discontinuity in academic medical centers: strategies for a safe and effective resident sign-out. J Hosp Med. 2006;1:257–66.

    Article  PubMed  Google Scholar 

  5. British Medical Association. Safe handover: safe patients. Guidance on clinical handover for clinicians and managers. London: British Medical Association; 2004.

    Google Scholar 

  6. Royal College of Surgeons. Safe handover: guidance from the working time directive working party. London: The Royal College of Surgeons of England; 2007. p. 1–7.

    Google Scholar 

  7. Warrier S. Improving physician hand-offs. Med Health R I. 2011;94:344–5.

    PubMed  Google Scholar 

  8. Gordon M. Training on handover of patient care within UK medical schools. Med Educ Online. 2013;18:369.

    Google Scholar 

  9. Van Eaton E. Handoff improvement: we need to understand what we are trying to fix. Jt Comm J Qual Patient Saf. 2010;36:51.

    PubMed  Google Scholar 

  10. Patterson ES, Wears RL. Patient handoffs: standardized and reliable measurement tools remain elusive. Jt Comm J Qual Patient Saf. 2010;36:52–61.

    PubMed  Google Scholar 

  11. Jeffcott SA, Evans SM, Cameron PA, Chin GSM, Ibrahim JE. Improving measurement in clinical handover. Qual Saf Health Care. 2009;18:272–6.

    Article  CAS  PubMed  Google Scholar 

  12. Van Eaton EG, Horvath KD, Lober WB, Rossini AJ, Pellegrini CA. A randomized, controlled trial evaluating the impact of a computerized rounding and sign-out system on continuity of care and resident work hours. J Am Coll Surg. 2005;200:538–45.

    Article  PubMed  Google Scholar 

  13. Bhabra G, Mackeith S, Monteiro P, Pothier DD. An experimental comparison of handover methods. Ann R Coll Surg Engl. 2007;89:298–300.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Ferran NA, Metcalfe AJ, O’Doherty D. Standardised proformas improve patient handover: Audit of trauma handover practice. Patient Saf Surg. 2008;2:24.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Ferran NA, Metcalfe AJ. Audit of handover practice. Ann R Coll Surg Engl. 2008;90:350.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Darbyshire D, Gordon M, Baker P. Teaching handover of care to medical students. Clin Teach. 2013;10:32–7.

    Article  PubMed  Google Scholar 

  17. Farnan JM, Paro JAM, Rodriguez RM, Reddy ST, Horwitz LI, Johnson JK, Arora VM. Hand-off education and evaluation: piloting the observed simulated hand-off experience (OSHE). J Gen Intern Med. 2009;25:129–34.

    Article  PubMed Central  Google Scholar 

  18. Telem DA, Buch KE, Ellis S, Coakley B, et al. Integration of a formalized handoff system into the surgical curriculum: resident perspectives and early results. Arch Surg. 2011;146(1):89–93.

    Article  PubMed  Google Scholar 

  19. Horwitz LI, Moin T, Green ML. Development and implementation of an oral sign-out skills curriculum. J Gen Intern Med. 2007;22:1470–4.

    Article  PubMed Central  PubMed  Google Scholar 

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Correspondence to Nicholas A. Ferran MBBS, MSc, FRCS .

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© 2014 Springer-Verlag London

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Grundy, T.J., Ferran, N.A. (2014). Handovers: The ‘Hidden Threat’ to Patient Safety. In: Stahel, P., Mauffrey, C. (eds) Patient Safety in Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4369-7_17

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  • DOI: https://doi.org/10.1007/978-1-4471-4369-7_17

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4368-0

  • Online ISBN: 978-1-4471-4369-7

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