“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).