Answer to "What is handover of care"

 

Handovers (or handoffs) can be defined as the transfer of patient information and responsibility from one health care provider to another during a transition of care.  This can occur across many different settings (e.g inpatient to inpatient provider, inpatient to outpatient provider).      

 

Although handovers have always existed, recently there has been an increase in attention paid to them with a push to instituting formal handover curricula largely due to the following:   

 

  • Handovers were found to lead to communication failures, uncertainty in patient care, delays in diagnosis and treatment, near misses, and redundancy and inefficiencies.

  • Both the Joint Commission and the World Health Organization (WHO) recommended that health care organizations develop a standardized approach to handoff communication and incorporate handoff training into their curriculum. 

  • The UK Department of Health seminal report ‘An organization with a memory’ found lack of face to face handover a key element in a number of high profile adverse events, with this one of the priority areas for action.

  • The US Joint Commission identified lapses in communication as the leading cause of sentinel events in their 2007 Report on Quality and Safety.

  • Limiting the time that health care workers can work; the American Council of Graduate Medical Education’s (ACGME) postgraduate work hour restrictions led to the unintended consequence of increasing patient handovers. 

 

 

References

AGCME (2017) Common Program Requirements, Accreditation Council for Graduate medical Education. Available at: https://www.acgme.org/What-We-Do/Accreditation/Common-Program-Requirements (Accessed: 12 March 2019).

Department of Health (2000) An organisation with a memory: report of an expert group on learning from adverse events in the NHS. London: Stationery Office. Available at: https://www.aagbi.org/sites/default/files/An%20organisation%20with%20a%20memory.pdf. (Accessed: 12 March 2019).

Horwitz, L. I., Moin, T., Krumholz, H. M., Wang, L., et al. (2008) ‘Consequences of Inadequate Sign-out for Patient Care’, Archives of Internal Medicine, 168(16), pp. 1755–1760. https://doi.org/10.1001/archinte.168.16.1755.

Royal College of Physicians and Surgeons of Canada (2015) CanMEDS 2015 Framework. Available at: http://canmeds.royalcollege.ca/en/framework (Accessed: 12 March 2019).

The Joint Commission (2007) Improving America’s hospitals: the Joint Commission’s annual report on quality and safety 2007. Oakbrook Terrace, IL: The Joint Commission. Available at: https://www.jointcommission.org/assets/1/6/2007_Annual_Report.pdf (Accessed: 12 March 2019).

WHO (2007) ‘Communication during Patient Hand-Overs’. World Health Organisation. Available at: https://www.who.int/patientsafety/solutions/patientsafety/PS-Solution3.pdf. (Accessed: 12 March 2019).

© 2019 AMEE

 

Privacy