Category Archives: IT-Shift handover

Shift handover research gets funding

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Just stumbled across the good news that £500K has been found to fund research in shift handover for healthcare in the UK. The City University’s Centre for HCI Design has been awarded £494,777 to be precise by the Engineering and Physical Sciences Research Council (the UK Government’s leading funding agency for research and training in engineering and the physical sciences):“While there have been small-scale studies of clinical handover in specific settings, including our own study of a paediatric ward on the ACE project, there is a lack of basic research. We will address this shortcoming in the GHandI project [my note: GHandI = Generic Handover Investigation] with an extensive investigation of handover as it is only by achieving a clear understanding of the ‘work’ that handover accomplishes that we will be able to improve the practice. For example, there is evidence that handover contributes to patient safety by accomplishing work other than the immediate transfer of responsibility for care of the patient.”It is within this context that the current proposal is situated, the overall aim of which is to conduct a detailed investigation of clinical handover and its contribution to patient safety by developing and evaluating a generic theoretical model of handover and deriving detailed recommendations and prototypes for innovative handover support technology.

“With the support of our collaborators, we plan to study handovers in ten clinical settings, ranging from ambulance ‘retrieval’ services to inter-specialty transfers to shift handovers in paediatric intensive care units.” Be interesting to know whether the WHO Collaborating Centre for Patient Safety Solutions (which recommends SBAR) is one of the collaborators?

There’s also the shift handover research already carried out in Canada to refer to: Transfer of Accountability: Transforming Shift Handover to Enhance Patient Safety, Kim Alvarado, Ruth Lee, Emily Christoffersen, Nancy Fram, Sheryl Boblin, Nancy Poole, Janie Lucas and Shirley Forsyth. (Healthcare Quarterly, 9(Sp) 2006: 75-79).I guess they’ve also seen the US patient safety tool, the SBAR (Situation-Background-Assessment-Recommendation) technique which “provides a framework for communication between members of the health care team about a patient’s condition. SBAR is an easy-to-remember, concrete mechanism useful for framing any conversation, especially critical ones, requiring a clinician’s immediate attention and action. It allows for an easy and focused way to set expectations for what will be communicated and how between members of the team, which is essential for developing teamwork and fostering a culture of patient safety.”

And of course there is existing tried and tested shift handover solutions currently used in industry such as Lifetrack, “which was developed as part of a sponsored research program involving BP, Honeywell Control and the University of Cambridge. The project spent 2 years understanding the social, communication and information dimensions of shift hand-over and operations logging”. Anything from Cambridge has got to be worth a look too, I would have thought (and indeed I added a posting on Lifetrack, together with one on SBAR, to the Medicexchange Forum).

Reality checkpointPhoto by Stuart Glendinning Hall

Shift handover & WHO report

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Interested to read on Reuters the WHO report on safety which again underlines the importance of good ward communications. PDF of the ‘Communication During Patient Hand-Overs’ summary here too.

GENEVA (Reuters) – Errors in medical care affect 10 percent of patients worldwide, according to the United Nations health agency, which issued a checklist on Wednesday to help doctors and nurses avoid common mistakes.

The nine key points listed by the World Health Organisation (WHO) include double-checking similar-sounding medication names, ensuring patients are correctly identified, and improving hand hygiene to avoid preventable infections.

“Health care errors affect one in every 10 patients around the world,” WHO Director-General Margaret Chan said in a statement. “Implementing these solutions is a way to improve patient safety.”

The WHO urged health workers to improve communication and assure medication accuracy during transitions in patient care, carefully control concentrated electrolyte solutions, avoid misconnections in catheters and other tubing, use injecting devices only once, and ensure the correct procedure is performed at the right place on the body.

Liam Donaldson, chair of the WHO’s World Alliance for Patient Safety and Chief Medical Officer for Britain, said the checklist should help reduce “the unacceptably high number of medical injuries around the world.”

At any one time, some 1.4 million people worldwide suffer from hospital-acquired infections, according to WHO figures. One in every 136 patients in the United States becomes severely ill as a result of an infection caught in hospital.

“Wrong site procedures” on the body — including errors about the side, organ, implant or person to be operated upon — are infrequent but not rare, the agency said, citing communication breakdowns as the cause of many of these.

Unsafe medical injections, with reused and unsterilised equipment, are believed to occur most often in South Asia, the Middle East and the Western Pacific, a region including China, Japan, Vietnam and Australia.

In sub-Saharan Africa, as many as 18 percent of injections are given with reused syringes or unsterilised needles, increasing the risk of hepatitis and HIV, the WHO said.