Final Report Summary - SAFE-HANDOVER (Handover practices assuring patient safety at care transitions from anaesthesia)
Transfer of responsibility and information about patient care between clinicians (i.e. handover) is a safety-critical phase of a patient's journey. Research on adverse events in healthcare shows that problems in coordination and communication during patient handover represent a major threat to patient safety in a multitude of healthcare settings. Thus, patient handover has recently become a key process addressed by research priorities and by system-based interventions to improve patient safety.
The SAFE-HANDOVER project aimed at contributing to scientific knowledge concerning safe transitions of care by identifying handover strategies that help clinicians to assure continuity of care and maintain safety of surgical patients during care transitions between anaesthesia and the recovery room or the intensive care unit (ICU). The SAFE-HANDOVER project consisted of three work packages:
1) a field study of patient handover using ethnographic observations and interviews with subject matter experts to extract aspects of current handover practice which help to create and maintain safety for patients being transferred from anaesthesia to recovery room / ICU,
2) the development of a measure for assessing the quality and safety of patient handover from anaesthesia to recovery room / ICU that integrates aspects of 'technical' (i.e. information accuracy and completeness) and 'non-technical' performance (i.e. cognitive and social skills involving decision making and team work), and
3) a field study using structured observations to investigate the effectiveness of different handover practices in relation to the safety of patient transfers (determined using the above measure).
The results of the SAFE-HANDOVER project highlight several aspects the clinicians perceive as critical aspect to be considered when moving handover improvement efforts forward (i.e. a need for structured handover and formal training taking into account safety-relevant themes such as unclear transitions of responsibility and barriers to speaking up). Moreover, the project identified handover practices related to higher ratings of handover quality and, thus, information on specific behaviours that need to be trained when aiming at effective handover communication.
The SAFE-HANDOVER project contributes to the advancement of handover research through the methods developed to systematically describe handover practices using structured observation and to evaluate handover quality. The project also contributes to improving patient safety by providing important input on effective patient handover guidelines and training modules that can be integrated into the education of undergraduate and practising health professionals.
The SAFE-HANDOVER project aimed at contributing to scientific knowledge concerning safe transitions of care by identifying handover strategies that help clinicians to assure continuity of care and maintain safety of surgical patients during care transitions between anaesthesia and the recovery room or the intensive care unit (ICU). The SAFE-HANDOVER project consisted of three work packages:
1) a field study of patient handover using ethnographic observations and interviews with subject matter experts to extract aspects of current handover practice which help to create and maintain safety for patients being transferred from anaesthesia to recovery room / ICU,
2) the development of a measure for assessing the quality and safety of patient handover from anaesthesia to recovery room / ICU that integrates aspects of 'technical' (i.e. information accuracy and completeness) and 'non-technical' performance (i.e. cognitive and social skills involving decision making and team work), and
3) a field study using structured observations to investigate the effectiveness of different handover practices in relation to the safety of patient transfers (determined using the above measure).
The results of the SAFE-HANDOVER project highlight several aspects the clinicians perceive as critical aspect to be considered when moving handover improvement efforts forward (i.e. a need for structured handover and formal training taking into account safety-relevant themes such as unclear transitions of responsibility and barriers to speaking up). Moreover, the project identified handover practices related to higher ratings of handover quality and, thus, information on specific behaviours that need to be trained when aiming at effective handover communication.
The SAFE-HANDOVER project contributes to the advancement of handover research through the methods developed to systematically describe handover practices using structured observation and to evaluate handover quality. The project also contributes to improving patient safety by providing important input on effective patient handover guidelines and training modules that can be integrated into the education of undergraduate and practising health professionals.