Clinical handover of the trauma and medical patient: a structured approach
Abstract
Handovers are vital to the continuity of patient care and can influence patient outcome. Several structures exist to facilitate handover delivery but further work is needed to prospectively evaluate them.
This article advocates the implementation of a suitable pre-hospital handover template and the introduction of handover training. We believe the introduction of trauma networks into the UK provides the ideal opportunity to prompt hospitals and ambulance services to co-operate to standardise the approach to handover, improve training and carry out further prospective research into the most effective methods of patient handover.
South East Coast Ambulance Service NHS Foundation Trust (SECamb) covers the whole of south east England, including the counties of Kent, Surrey and Sussex. In 2012, SECamb responded to approximately 735 984 calls (SECamb data). Of these, 55 506 were categorised as a ‘trauma call’, indicating the potential for significant injury. Of these, there were approximately 80 trauma and medical pre-alerts to a receiving hospital per day, which equates to approximately 29 200 hospital prealerts per year. Kent, Surrey and Sussex Helicopter Emergency Medical Service (HEMS) operate within the same geographical region, undertaking approximately 1 500 missions per year to both medical and trauma emergencies. All of these trauma and high acuity medical patients require rapid, accurate, handover of complex information between the pre-hospital ambulance or HEMS team and admitting hospital emergency medical team.
Quality of handover can have an impact on patient care. The World Health Organization (WHO) has cited that within their ‘High 5s’ project that communication failures during medical handover is an area of concern and recommend a Standard Operating Procedure (SOP) is used for patient handover. Each SOP summarises a variety of issues such as potential barriers and makes recommendation for solutions (World Health Organization, 2013).
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