Background: Inadequate handover in emergency care is a threat to patient safety. Handover across care boundaries poses particular problems due to different professional, organisational and cultural backgrounds. While there have been many suggestions for standardisation of handover content, relatively little is known about the verbal behaviours that shape handover conversations. This paper explores both what is communicated (content) and how this is communicated (verbal behaviours) during different types of handover conversations across care boundaries in emergency care.
Methods: Three types of interorganisational (ambulance service to emergency department (ED) in 'resuscitation' and 'majors' areas) and interdepartmental handover conversations (referrals to acute medicine) were audio recorded in three National Health Service EDs. Handover conversations were segmented into utterances. Frequency counts for content and language forms were derived for each type of handover using Discourse Analysis. Verbal behaviours were identified using Conversation Analysis.
Results: 203 handover conversations were analysed. Handover conversations involving ambulance services were predominantly descriptive (60%-65% of utterances), unidirectional and focused on patient presentation (75%-80%). Referrals entailed more collaborative talk focused on the decision to admit and immediate care needs. Across all types of handover, only 1.5%-5% of handover conversation content related to the patient's social and psychological needs.
Conclusions: Handover may entail both descriptive talk aimed at information transfer and collaborative talk aimed at joint decision-making. Standardisation of handover needs to accommodate collaborative aspects and should incorporate communication of information relevant to the patient's social and psychological needs to establish appropriate care arrangements at the earliest opportunity.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316834 | PMC |
| http://dx.doi.org/10.1136/emermed-2013-202977 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
[Early detection of alcohol use: discuss alcohol use to prevent damage].
Ned Tijdschr Geneeskd
December 2024
Jellinek, Amsterdam.
Introduction: Health professionals do not routinely ask patients about alcohol use, although it is associated with a range of somatic and psychological problems. Therefore, alcohol use may not be recognized as the cause of a health problem, which may result in worsening of the situation, incorrect diagnosis or incorrect treatment. This is illustrated by three cases from different clinical practices: the emergency department, the hospital ward and the general practice.
View Article and Find Full Text PDFIs it gossip or feedback? Surgical attendings' perceptions of gossip within residency.
J Surg Educ
October 2024
Department of Health Professions Education, MGH Institute for Health Professions Education, Boston, MA; Department of Surgery, Baylor Scott & White Health, Temple, TX.
Objective: Gossip-evaluative talk about an absent third party-exists in surgical residency programs. Attending surgeons may engage in gossip to provide residents with feedback on performance, which may contribute to bias. Nevertheless, the perspectives of attending surgeons on gossip has not been studied.
View Article and Find Full Text PDFIntroduction: 'Hybrid' interventions in which some intervention components are fixed across sites and others are flexible (locally created) are thought to allow for adaptation to the local context while maintaining fidelity. However, there is little evidence regarding the challenges and facilitators of implementing hybrid interventions. This paper reports on a process evaluation of a patient safety hybrid intervention called Your Care Needs You (YCNY).
View Article and Find Full Text PDFDescriptive feedback with targeted education to improve telephonic escalation of care: a simulation-based study.
BMC Med Educ
March 2024
Department of General Paediatrics, Mackay Base Hospital, 4740, Mackay, QLD, Australia.
Background: Awareness of communication failures in healthcare has necessitated the implementation of standardized, validated handover tools such as Identification, Situation, Background, Assessment, Recommendation (ISBAR). Although educational sessions improve communication, the effectiveness of individualized care escalation communication training is unknown. The primary aim was to conduct a simulation-based study to assess individualized one-on-one communication training for junior medical doctors for improving care escalation in pediatric emergencies.
View Article and Find Full Text PDFImplementing the IMIST-AMBO tool for paramedic to trauma team handovers: a video review analysis.
CJEM
May 2023
Tory Regional Trauma Program and Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Objective: Patient handover between paramedics and the trauma team is vulnerable to communication errors that may adversely affect patient care. This study assesses the feasibility of a handover tool, IMIST-AMBO (acronym of categories), implementation in the trauma bay and evaluates the degree to which it improves handover metrics.
Methods: This is a prospective observational cohort study conducted at Canada's largest level-one trauma center.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!