Handover; skills to enhancing the PHEM – EM interface

Authors: Sophie Jefferys, Douglas Maxwell, David Fitzpatrick, John Paul Loughrey / Editor: Lauren Fraser / Codes: Published: 15/10/2021

Description:

Handover of critical care patients carries significant potential risk. Misunderstanding, misinterpretation or omitted information can have significant adverse impact on patient outcome. The handover from the pre-hospital team to the receiving hospital team carries additional potential hazards due to the time critical nature and the multiple human factors involved.

Learning objectives:

  • Clarify what information a pre-hospital practitioner can provide
  • Explain how information is shared from the pre-hospital team including the pre-alert and face-to-face handover
  • Introduce ATMIST / AMPLE handover tools
  • Understand team resource management techniques to enhance handover
  • Advocate for a hands-off handover when safe to do so

References

  1. Manser T, Foster S. Effective handover communication: an overview of research and improvement efforts. Best Pract Res Clin Anaesthesiol. 2011 Jun;25(2):181-91. doi: 10.1016/j.bpa.2011.02.006. PMID: 21550543.
  2. Solet DJ, Norvell JM et al. Lost in translation: challenges and opportunities in physician-to-physician communication during patient handoffs. Acad Med. 2005 Dec;80(12):1094-9.
  3. World Health Organisation. Communication during patient hand-overs. Switzerland. WHO Press, 2007.
  4. Slope R, Exploration of handover communication in military and NHS emergency care settings [Thesis for the degree of Doctor of Philosophy]. Southampton. University of Southampton; 2017.
  5. Murray SL, Crouch R, Ainsworth-Smith M. Quality of the handover of patient care: a comparison of pre-Hospital and Emergency Department notes. Int Emerg Nurs. 2012 Jan;20(1):24-7.
  6. D Maxwell. Promotion of a standardised, structured process in the handover of critically ill patients into the resuscitation room: A Quality Improvement Project. 2017.
  7. Iedema R, Ball C, et al. Design and trial of a new ambulance-to-emergency department handover protocol: ‘IMIST-AMBO’. BMJ Qual Saf. 2012 Aug;21(8):627-33. doi: 10.1136/bmjqs-2011-000766. Epub 2012 May 23. PMID: 22626739.
  8. NICE Guideline 32; Structured patient handovers. 2017.
  9. JESIP Interoperability guideline; M/ETHANE.
  10. Fitzpatrick, D, McKenna, M, Duncan, E.A.S. et al. Critcomms: a national cross-sectional questionnaire-based study to investigate prehospital handover practices between ambulance clinicians and specialist prehospital teams in Scotland. Scand J Trauma Resusc Emerg Med 26, 45 (2018). https://doi.org/10.1186/s13049-018-0512-3
  11. Budd HR, Almond LM, Porter K. A survey of trauma alert criteria and handover practice in England and Wales. Emerg Med J. 2007 Apr;24(4):302-4.
  12. National Confidential Enquiry into Patient Outcome and Death. Trauma: Who Cares? NCEPOD report. 2007.
  13. National Clinical Guideline Centre (UK). Major Trauma: Service Delivery. London: National Institute for Health and Care Excellence (UK); 2016 Feb. (NICE Guideline, No. 40.) 7, Pre-alert processes. 
  14. Sheppard JP, Lindenmeyer A, et al. Prevalence and predictors of hospital prealerting in acute stroke: a mixed methods study. Emerg Med J. 2016 Jul;33(7):482-8. doi: 10.1136/emermed-2014-204392. Epub 2016 Feb 23. PMID: 26949969; PMCID: PMC4941194.
  15. Ashton C, Sammut-Powell C, Birleson E, et al. Implementation of a prealert to improve in-hospital treatment of anticoagulant-associated strokes: analysis of a prehospital pathway change in a large UK centralised acute stroke system. BMJ Open Quality 2020;9:e000883.
  16. C Reid. Analysing Difficult Resuscitation Cases. Zero Point Survey. Resus.Me. 2018. [Accessed October 12, 2020].
  17. C Reid, Brindley P, et al. The Korean Society of Emergency Medicine; Zero point survey: a multidisciplinary idea to STEP UP resuscitation effectiveness. CEEM. 2018. [Accessed October 12, 2020].
  18. Carter AJ, Davis KA, Evans LV, Cone DC. Information loss in emergency medical services handover of trauma patients. Prehosp Emerg Care. 2009 Jul-Sep;13(3):280-5. doi: 10.1080/10903120802706260. PMID: 19499462.
  19. Fitzpatrick D, Maxwell D, Craigie A. The feasibility, acceptability and preliminary testing of a novel, low-tech intervention to improve pre-hospital data recording for pre-alert and handover to the Emergency Department. BMC Emerg Med. 2018 Jun 25;18(1):16. doi: 10.1186/s12873-018-0168-3. PMID: 29940885; PMCID: PMC6019792.

Additional Resources

Leave a Reply