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Acute care toolkit 1: Handover

Handover is the system by which the responsibility for immediate and ongoing care is transferred between healthcare professions. Changing work patterns mean that establishing standards for handover should be a priority.

Key recommendations

  • Improvement and standardisation of handover are vital keys to improvement in efficiency, patient safety, and patient experience.
  • Handover should be ‘owned’ by the trust or hospital, who accept responsibility for ensuring that the systems and conditions are in place to allow effective handover, eg overlapping duty times; rationalisation of shift patterns of different roles (doctors and nurses); and the provision of an appropriate environment.
  • Doctors can learn from other professionals’ experience and adopt or adapt the practice for collaborative transprofessional use, eg nurses have more experience of shift working, and therefore of handover.
  • There is a need to define common core principles for handover, which can be adapted locally. For example, a standardised proforma for written handover is essential, preferably in conjunction with face-to-face verbal handover. The sickest patients may require bedside handover, in the presence of senior medical staff, as is often seen in intensive care units.
  • Furthermore, in the current technological climate, where possible, electronic handover processes should be encouraged.
  • All standardisation should be Academy of Medical Royal Colleges (AoMRC) compliant.
  • Education and training will be essential, and need to cover generic and local requirements, the use of specific terminology, how to prioritise patients and work, and training in specific communication techniques and skills.

Patients expect, and should have, a designated consultant and nurse to coordinate the multidisciplinary team. However, at times (eg night, weekends or during an emergency admission) the responsibility for care must pass from one team, or consultant, to another.

This toolkit focuses on handover, defining good handover, looking at the current problems often experienced, and setting out recommendations for improved, standardised handover protocols. Also provided are two templates, a handover proceedings sheet and a form for out-of-hours handover, which can help staff to implement the recommendations of the toolkit.