Factors impeding the effective utilisation of an electronic patient report form during handover from an ambulance to an emergency department.

We investigated the reasons why the transition from paper to electronically formatted records during patient handover between ambulance crews and emergency department staff in a North East England Emergency Department has not always been viewed positively. Interviews with seven paramedics and three emergency department staff were conducted in addition to observations of 74 ambulance staff during 37 handovers in the emergency department. In just over half of the handovers (20), paramedics found it necessary to provide written information to aid emergency department staff, in addition to that recorded electronically.

Making clinical governance work.

The current focus on quality and safety means most doctors have negative views about clinical governance. But done properly, clinical governance has the power to improve NHS performance