Doctors' shift handovers in acute medical units by Michelle Amondi Raduma-Tomás, 2012 at the University of Aberdeen. EThOS ID 558660
Raduma-Tomás looks to describe the ideal handover process when one shift of medical staff ends and another begins and looks at what actually happens in two Scottish Acute Medical Units. Unsurprisingly for anyone who has been an in-patient it seems a lot of information gets lost, mostly due to interruptions, patient workload and a lack of standardised procedures.
Having had 2 children in the last 5 years, one of whom has had a few stays in hospital, I can attest that I've had to be on the ball when I know a handover is coming up: it puts staff out-of-action for at least half an hour and everything you've worked so hard to communicate for that last 12 hours is not passed on, more often than not. I have found that you have to actively manage your own healthcare and be proactive at every step: not so easy when you're laid up after an operation!
So it's good that this study has been done, and more besides in recent years (just search medical handover in EThOS) but the findings are very worrying, not least that there isn't a standarised procedure.
I am a big fan of the writings of Atul Gawande and his The Checklist Manifesto is a short, quick and fascinating read with practical and far-reaching implications. It puts the work of experts into checklists for the safety of everyone involved. One of Raduma-Tomás' conclusions is that "A simple, handover process checklist may ensure critical handover tasks have been achieved prior to any shift change" and that information transfer would then be less susceptible to interruption for instance.
There is something for everyone in this book by Gawande, a polymath surgeon, give it a go.
Interesting. From a professional perspective I can definitely attest that checklists are invaluable for any sort of handover or state change (software delivery in my case). Without using them it's almost inevitable that something which "cannot possibly be forgotten" will get overlooked.
ReplyDeleteHe is keen to point out that the checklist approach doesn't mean the process is simple, one step might be a highly complex procedure that took years to learn but that it does need to be documented. He has an amazing example of what happens on huge building projects to ensure all information is captured and shared. I'm a big fan of his, not least because he writes so well.
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