Patient safety and human factors: RCN programme - handover

Situation

Handovers have been identified as a communication 'hotspot'. Misinformation, missing information or untimely information contributes to a significant number of patient safety incidents and workflow problems (British Medical Association 2004). Effective communication is identified as one of the key Principles of Nursing Practice (Royal College of Nursing 2010; Casey and Wallis 2011).

Background

The goal of this initiative is to develop standards for the structure and content of hospital handover records. The Department of Health (England) has produced three overarching principles:

The data items constitute a core set of issues which must be used in any and every clinical handover.
The core set of issues is necessary, but not sufficient for any and every clinical handover – each health care setting will have its own, additional set of essential data items to be transferred in a clinical handover.
The guiding principles and related data items for ensuring safer clinical handovers are additional to, and not instead of, all usual clinical safety assurance measures (e.g. Data Set Change Notices 14/2009, 18/2009).

The data items relating to the guiding principles can be seen here (Royal College of Physicians 2012).

Actions

An extensive consultation with the RCN, medical royal colleges, specialist societies, and patients and carers has been undertaken. Work was initiated on the headings to support the handover process and provide a record of what was communicated at handover. Additional, site specific or specialty specific data items will also be developed.

Results

Core clinical headings for electronic record systems are to be published. The Royal College of Physicians will be conducting a review of data items under these headings during 2012–13. The work is funded by the Department of Health (England).