The University for business

1
Practical challenges of studying handover

• Rebecca Randell, Julia Galliers, Stephanie
  Wilson, Peter Woodward
• Centre for HCI Design

2

• 545 p.m. The on call SHO arrives following a
  telephone conversation with the nurse who bleeped
  him. The nurse goes to pass him the patients
  notes but he says no. The nurse says shes spoken
  to the palliative care nurse who has given
  recommendations for pain management drugs for the
  patient the nurse goes to give the sheet to him
  but he tells her to just read it out. As the
  nurse reads, he writes up a Prescription and
  administration record and drug chart. On the
  last drug, he asks Whats that for? Sickness?
  The nurse says Yeah. Afterwards, the nurse
  comments that they take you at face value he
  wrote up and signed a prescription for morphine
  based on the nurses request. (CS2/RR/26July)

3
Methods

• Study of handover in a general medical ward and
  an emergency assessment unit
• Ethnographic observation, supported by informal
  interviews and collection of documents related to
  handover
• Over 100 hours of observation in each setting
• GHandI, EPSRC EP/D078636/1

4
What is handover?

• The transfer of professional responsibility and
  accountability for some or all aspects of care
  for a patient, or group of patients, to another
  person or professional group on a temporary or
  permanent basis.

5
Roles and responsibilities

• To attend and assess patients with acute
  deterioration of health To resuscitate patients,
  while awaiting arrival of expert assistance or
  transfer Resuscitation after cardiac arrest.
• - Academy of Medical Royal Colleges, 2003

6
Handover as process

• More complex than simply moving from not being
  responsible to being responsible
• Active vs. non-active responsibility
• Move from non-involvement to involvement
• Has relevance beyond on call staff
• Collaboration of a range of health care
  professionals

7
Implications

• To study handover
• Need to look beyond moment of handover
• Need to look at how it is mediated by other
  health professionals
• To support handover
• Need to support a range of handovers
• Have design choices relating to what to support