Assessing the quality of patient handover in different clinical settings
The process of providing healthcare is inherently interdisciplinary involving physicians, nurses and allied health professionals from different specialties attending to the patient at various points in time. In this context effective handover practices (i.e., mechanisms for transferring information, responsibility, and authority) are critical to ensure continuity of care and patient safety. Aims: This study aimed at a) developing a new rating tool for handover quality that goes beyond mere information transfer, b) investigating the relationships between handover characteristics and perceived handover quality, and c) exploring potential differences in these relationships in three different clinical settings. Methods: We have developed a new rating tool for assessing the quality of patient handover from two different perspectives (self-rating and external rating). The rating tool does not only include questions on information accuracy and completeness but also on teamwork during handover. The rating tool was piloted during a total of 80 patient handovers performed in three different handover settings in a tertiary care hospital: 1.paramedic to emergency room staff, 2. anesthesia care provider to post-anesthesia care unit (PACU), and 3. PACU nurse to ward nurse. The quality of each patient handover was assessed independently by the clinician handing over the patient, the clinician receiving the patient and by a human factors expert. Results: Exploratory factor analysis produced a three factor solution. The results of subsequent regression analysis showed that all three factors (i.e. information transfer, establishing a shared understanding, and working atmosphere) were significant predictors of perceived handover quality. Although the ratings of handover quality were generally very positive, we were able to identify differences between perceptions of the three independent raters (e.g. ratings of the human factors expert were usually lower than those of the clinicians) and between clinical settings (e.g. differences in the relative contribution of the three handover factors to overall handover quality). Conclusions: This study provides important insights into the complex concept of handover quality. We have developed and tested a rating tool that is feasible and comprehensive by including not only characteristics of the information process but also aspects of teamwork and, thus, provides an important tool for future research on patient handover.
Tanja Manser Simon Foster Stefan Gisin Dalit J(a)ckel-Lang Wolfgang Ummenhofer
Center for Organizational and Occupational Sciences, ETH Zurich, Switzerland Department of Anaesthesia, University Hospital Basel, Switzerland
国际会议
17th World Congress on Ergonomics(第十七届国际人类工效学大会)
北京
英文
1-7
2009-08-09（万方平台首次上网日期，不代表论文的发表时间）