This action states

The health service organisation, in collaboration with clinicians, defines the:

  1. Minimum information content to be communicated at clinical handover, based on best-practice guidelines
  2. Risks relevant to the service context and the particular needs of patients, carers and families
  3. Clinicians who are involved in the clinical handover

Intent

Accurate and relevant information about a patient’s care is communicated and transferred at every clinical handover to ensure safe, high-quality patient care.

Reflective questions

How does the health service organisation describe the minimum information content to be communicated at each clinical handover?

What processes are used to ensure that the health service organisation collaborates with the clinicians who are involved in clinical handover when determining the minimum information content for different handovers?

Key task

  • Collaborate with clinicians to define the minimum information content to be communicated for each type of clinical handover identified within the organisation (see Action 6.4).

Strategies for improvement

Hospitals

Define the minimum information content for all clinical handovers relevant to the service. The minimum information required may differ, depending on the type of clinical handover and the situation in which clinical handover is occurring.

One way to define the minimum information content is by ‘dot voting’. This is a simple way to collect opinions from the whole team involved in the transfer of care about what information should be included.1

Document the minimum information content for different clinical handovers, and make this easily available to the workforce to ensure that all participants involved in a handover are aware of what the minimum information content is for that particular handover, and their roles and responsibilities for communicating and receiving this information. Provide orientation and training to support the workforce in effectively transferring the correct information (see Action 6.1). Provide guidance on the overarching minimum information required for all handovers, and allow this to be adapted and refined to the different contexts in which handovers occur in the organisation. At a minimum, consider the information that is required to be communicated across the NSQHS Standards.

Examples of frameworks for defining minimum information content

The Royal Hobart Hospital designed an overarching minimum information content framework as part of the National Clinical Handover Initiative. It includes considering:

  • Environmental awareness
  • Patient identification (see Action 6.5, which requires three approved patient identifiers)
  • History, evaluation and management
  • Responsibility, risk management and action plans
  • Accountability
    • patient – accountability for the care of the patient is transferred to the incoming responsible individual or team, and a patient’s preference of care is clearly communicated
    • profession and colleagues – the incoming team understands the tasks ahead, including the consultant in charge of the overall care of the patient
    • organisation – accountable for ensuring the most efficient patient flow through the organisation, and that all issues relating to discharge planning are transferred from one team to another.

Use of structured handover tools can help to provide a framework for communicating the minimum information content for clinical handovers. The iSoBAR framework is an example (Table 4).2

A ‘patient safety check’ process at the end of a handover can help to focus on the patient’s safety as a priority. This may include raising or reiterating any safety concerns, such as socioeconomic factors, alerts, allergies or risks.

Other examples of tools to help structure handover include:

  • ISBAR (Identify, Situation, Background, Assessment, Recommendation)
  • SBAR (Situation, Background, Assessment, Recommendation)
  • SHARED (Situation, History, Assessment, Risk, Expectation, Documentation)
  • I PASS the BATON (Introduction, Patient, Assessment, Situation, Safety concerns, Background, Actions, Timing, Ownership, Next).

These tools are designed to be flexible and adapted to suit local workforce environments and culture, and the purpose of the handover. They are available on the Commission's website.

isoBAR Framework

 

Day Procedure Services

Define the minimum information content for all clinical handovers relevant to the service. The minimum information required may differ, depending on the type of clinical handover and the situation in which clinical handover is occurring.

One way to define the minimum information content is by ‘dot voting’. This is a simple way to collect opinions from the whole team involved in the transfer of care about what information should be included.3

Document the minimum information content for different clinical handovers, and make this easily available to the workforce to ensure that all participants involved in a handover are aware of what the minimum information content is for that handover, and their roles and responsibilities for communicating and receiving this information. Provide orientation and training to support the workforce in effectively transferring the correct information (see Action 6.1). Provide guidance on the overarching minimum information required for all handovers, and allow this to be adapted and refined to the different contexts in which handovers occur in the organisation. At a minimum, consider the information that is required to be communicated across the NSQHS Standards.

Use of structured handover tools can help to provide a framework for communicating the minimum information content for clinical handovers. The iSoBAR framework is an example.2

A ‘patient safety check’ process at the end of a handover can help to focus on the patient’s safety as a priority. This may include raising or reiterating any safety concerns, such as socioeconomic factors, alerts, allergies or risks.

Other examples of tools to help structure handover are:

  • ISBAR (Identify, Situation, Background, Assessment and Recommendation)
  • SBAR (Situation, Background, Assessment, Recommendation)
  • SHARED (Situation, History, Assessment, Risk, Expectation, Documentation)
  • I PASS the BATON (Introduction, Patient, Assessment, Situation, Safety concerns, Background, Actions, Ownership, Timing, Next).

These tools are designed to be flexible and adapted to suit local workforce environments and culture, and the purpose of the handover. They are available on the Commission's website.

Examples of evidence

Select only examples currently in use:

  • Policy documents for clinical handover that specify the minimum information content to be communicated at each clinical handover relevant to the organisation
  • Structured communication tools that are used to effectively communicate the agreed minimum information content (for example, iSoBAR, ISBAR, SBAR)
  • Evidence that clinicians were involved in developing the minimum information content to be communicated at each clinical handover
  • Feedback from the workforce on the use of clinical handover policies, procedures or protocols.

MPS & Small Hospitals

MPSs or small hospitals that are part of a local health network or private hospital group should adopt or adapt and use the established clinical handover processes.

Small hospitals that are not part of a local health network or private hospital group should collaborate with clinicians to define the minimum information content to be communicated for each type of clinical handover identified in the organisation.

Document the minimum information content for different clinical handovers, and make this easily available to the workforce to ensure that all participants involved in a handover are aware of what the minimum information content is for that handover, and their roles and responsibilities for communicating and receiving this information. Provide orientation and training to support the workforce in effectively transferring the correct information (see Action 6.1). Provide guidance on the overarching minimum information required for all handovers, and allow this to be adapted and refined to the different contexts in which handovers occur in the organisation. At a minimum, consider the information that is required to be communicated across the NSQHS Standards.

Use of structured handover tools can help to provide a framework for communicating the minimum information content for clinical handovers. The iSoBAR framework is an example.2

A ‘patient safety check’ process at the end of a handover can help to focus on the patient’s safety as a priority. This may include raising or reiterating any safety concerns, such as socioeconomic factors, alerts, allergies or risks.

Other examples of tools to help structure handover include:

  • ISBAR (Identify, Situation, Background, Assessment and Recommendation)
  • SBAR (Situation, Background, Assessment, Recommendation)
  • SHARED (Situation, History, Assessment, Risk, Expectation, Documentation)
  • I PASS the BATON (Introduction, Patient, Assessment, Situation, Safety concerns, Background, Actions, Ownership, Timing, Next).

These tools are designed to be flexible and adapted to suit local workforce environments and culture, and the purpose of handover. They are available on the Commission's website.

Hospitals

Define the minimum information content for all clinical handovers relevant to the service. The minimum information required may differ, depending on the type of clinical handover and the situation in which clinical handover is occurring.

One way to define the minimum information content is by ‘dot voting’. This is a simple way to collect opinions from the whole team involved in the transfer of care about what information should be included.1

Document the minimum information content for different clinical handovers, and make this easily available to the workforce to ensure that all participants involved in a handover are aware of what the minimum information content is for that particular handover, and their roles and responsibilities for communicating and receiving this information. Provide orientation and training to support the workforce in effectively transferring the correct information (see Action 6.1). Provide guidance on the overarching minimum information required for all handovers, and allow this to be adapted and refined to the different contexts in which handovers occur in the organisation. At a minimum, consider the information that is required to be communicated across the NSQHS Standards.

Examples of frameworks for defining minimum information content

The Royal Hobart Hospital designed an overarching minimum information content framework as part of the National Clinical Handover Initiative. It includes considering:

  • Environmental awareness
  • Patient identification (see Action 6.5, which requires three approved patient identifiers)
  • History, evaluation and management
  • Responsibility, risk management and action plans
  • Accountability
    • patient – accountability for the care of the patient is transferred to the incoming responsible individual or team, and a patient’s preference of care is clearly communicated
    • profession and colleagues – the incoming team understands the tasks ahead, including the consultant in charge of the overall care of the patient
    • organisation – accountable for ensuring the most efficient patient flow through the organisation, and that all issues relating to discharge planning are transferred from one team to another.

Use of structured handover tools can help to provide a framework for communicating the minimum information content for clinical handovers. The iSoBAR framework is an example (Table 4).2

A ‘patient safety check’ process at the end of a handover can help to focus on the patient’s safety as a priority. This may include raising or reiterating any safety concerns, such as socioeconomic factors, alerts, allergies or risks.

Other examples of tools to help structure handover include:

  • ISBAR (Identify, Situation, Background, Assessment, Recommendation)
  • SBAR (Situation, Background, Assessment, Recommendation)
  • SHARED (Situation, History, Assessment, Risk, Expectation, Documentation)
  • I PASS the BATON (Introduction, Patient, Assessment, Situation, Safety concerns, Background, Actions, Timing, Ownership, Next).

These tools are designed to be flexible and adapted to suit local workforce environments and culture, and the purpose of the handover. They are available on the Commission's website.

isoBAR Framework

 

Day Procedure Services

Define the minimum information content for all clinical handovers relevant to the service. The minimum information required may differ, depending on the type of clinical handover and the situation in which clinical handover is occurring.

One way to define the minimum information content is by ‘dot voting’. This is a simple way to collect opinions from the whole team involved in the transfer of care about what information should be included.3

Document the minimum information content for different clinical handovers, and make this easily available to the workforce to ensure that all participants involved in a handover are aware of what the minimum information content is for that handover, and their roles and responsibilities for communicating and receiving this information. Provide orientation and training to support the workforce in effectively transferring the correct information (see Action 6.1). Provide guidance on the overarching minimum information required for all handovers, and allow this to be adapted and refined to the different contexts in which handovers occur in the organisation. At a minimum, consider the information that is required to be communicated across the NSQHS Standards.

Use of structured handover tools can help to provide a framework for communicating the minimum information content for clinical handovers. The iSoBAR framework is an example.2

A ‘patient safety check’ process at the end of a handover can help to focus on the patient’s safety as a priority. This may include raising or reiterating any safety concerns, such as socioeconomic factors, alerts, allergies or risks.

Other examples of tools to help structure handover are:

  • ISBAR (Identify, Situation, Background, Assessment and Recommendation)
  • SBAR (Situation, Background, Assessment, Recommendation)
  • SHARED (Situation, History, Assessment, Risk, Expectation, Documentation)
  • I PASS the BATON (Introduction, Patient, Assessment, Situation, Safety concerns, Background, Actions, Ownership, Timing, Next).

These tools are designed to be flexible and adapted to suit local workforce environments and culture, and the purpose of the handover. They are available on the Commission's website.

Examples of evidence

Select only examples currently in use:

  • Policy documents for clinical handover that specify the minimum information content to be communicated at each clinical handover relevant to the organisation
  • Structured communication tools that are used to effectively communicate the agreed minimum information content (for example, iSoBAR, ISBAR, SBAR)
  • Evidence that clinicians were involved in developing the minimum information content to be communicated at each clinical handover
  • Feedback from the workforce on the use of clinical handover policies, procedures or protocols.

MPS & Small Hospitals

MPSs or small hospitals that are part of a local health network or private hospital group should adopt or adapt and use the established clinical handover processes.

Small hospitals that are not part of a local health network or private hospital group should collaborate with clinicians to define the minimum information content to be communicated for each type of clinical handover identified in the organisation.

Document the minimum information content for different clinical handovers, and make this easily available to the workforce to ensure that all participants involved in a handover are aware of what the minimum information content is for that handover, and their roles and responsibilities for communicating and receiving this information. Provide orientation and training to support the workforce in effectively transferring the correct information (see Action 6.1). Provide guidance on the overarching minimum information required for all handovers, and allow this to be adapted and refined to the different contexts in which handovers occur in the organisation. At a minimum, consider the information that is required to be communicated across the NSQHS Standards.

Use of structured handover tools can help to provide a framework for communicating the minimum information content for clinical handovers. The iSoBAR framework is an example.2

A ‘patient safety check’ process at the end of a handover can help to focus on the patient’s safety as a priority. This may include raising or reiterating any safety concerns, such as socioeconomic factors, alerts, allergies or risks.

Other examples of tools to help structure handover include:

  • ISBAR (Identify, Situation, Background, Assessment and Recommendation)
  • SBAR (Situation, Background, Assessment, Recommendation)
  • SHARED (Situation, History, Assessment, Risk, Expectation, Documentation)
  • I PASS the BATON (Introduction, Patient, Assessment, Situation, Safety concerns, Background, Actions, Ownership, Timing, Next).

These tools are designed to be flexible and adapted to suit local workforce environments and culture, and the purpose of handover. They are available on the Commission's website.

References

  1. Davey N, Cole A. Safe communication: design, implement and measure. A guide to improving transfers of care and handover. Southampton (UK): Quality Improvement Clinic; 2015.
  2. Eggins S, Slade D, Geddes F, editors. Effective communication in clinical handover: from research to practice. Berlin: De Gruyter; 2016.
  3. Russell L, Doggett J, Dawda P, Wells R. Patient safety. Handover of care between primary and acute care: policy review and analysis. Prepared for the National Lead Clinicians Group by the Australian Primary Health Care Research Institute, Australian National University. Canberra: Australian Government Department of Health and Ageing; 2013.