Patient safety incidents associated with failures in communication reported from critical care units in the North West of England between 2009 and 2014

March 23, 2016

Source:  Journal of the Intensive Care Society [Epub ahead of print]

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Date of publication: February 2016

Publication type:  Journal article

In a nutshell:  Communication is central to the safe and effective delivery of critical care. This article presents a retrospective analysis of hospital incident reports attributed to communication that were generated by 30 intensive care units in the North West of England from 2009 to 2014. The study reviewed when during the critical care pathway incidents occur, the personnel involved, the method of communication used, the type of information communicated and the level of harm associated with the incident. The study found that patient safety incidents tend to occur when patients are transferred into or out of the intensive care unit and when information has to be communicated to other teams during the critical care stay. Ways that the patient handover process may be modified to improve communication and safety are also examined.

Length of publication:  1 webpage

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Clinical handover: the importance, problems and educational interventions to improve its practice

September 30, 2015

Source:  British Journal of Hospital Medicine 76/6 pp. 353-7

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Date of publicationJune 2015

Publication type:  Journal article

In a nutshell: The clinical handover is a complex area of advanced communication in medicine. It is becoming increasingly recognised as a situation where good communication is needed to ensure patient safety. This article outlines the importance of clinical handover and the need to make improvements.

Length of Publication:  5 pages

Some important notes:  Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library


Human factors in clinical handover: development and testing of a ‘handover performance tool’ for doctors’ shift handovers.

January 30, 2013

Source: Int J Qual Health Care  [Epub ahead of print]

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Date of publication:  December 2012

Publication type: Journal article

In a nutshell: This observational study tested a tool to help clinicians assess the quality and safety of shift handovers. The emphasis was on non-technical skills such as communication, teamwork, leadership, situation awareness and task management. Doctors at one hospital in England helped validate the tool, and handovers were videoed for analysis by human factors experts. Good communication was most likely to be associated with high quality ratings of handovers, followed by teamwork and situation awareness.

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.


Impact of a structured template and staff training on compliance and quality of clinical handover

December 3, 2012

Source:  International Journal of Surgery, vol/iss 10/9 pp.571-574

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Date of publication:  October 2012

Publication type:  Journal article

In a nutshell:  In this article, researchers assessed whether the quality of clinical handover in hospital could be improved for junior doctors by using a standardised and structured handover template. A computerised template was developed in accordance with handover guidelines by the Royal College of Surgeons of England. The template helped to promote quality of care, improve compliance to agreed standards and protect patient safety.

Length of Publication:  4 pages

Some important notes:  Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Acknowledgements:  The Heath Foundation


Identifying and categorizing patient safety hazards in cardiovascular operating rooms

July 30, 2012

Source:  BMJ Quality & Safety

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Date of publication:  May 2012

Publication type:  Journal article

In a nutshell:  This article looks at how an interdisciplinary team, working in cardiac surgery, looked at the patient journey from ward to operating room.  They looked at the way patients are transferred, and handoff after surgery trying to identify potential hazards and opportunities to improve patient safety.

Length of publication:  9 pages

Some important notes:   If an item requires an Athens username and password.  This article is available in full text to all NHS Staff using Athens, for more information about accessing full text fllow this link to find your local NHS Library


The ‘ABC of Handover’: impact on shift handover in the emergency department.

February 8, 2012

Source:  Emergency Medicine Journal  doi:  10.1136/emermed-2011-200201

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Date of publicationNovember 2011

Publication type:  Journal article

In a nutshell:  This article looks at the ‘ABC of Handover’, a tool for shift handover, and it’s effectiveness in the emergency department (ED).  The study covers 83 handover shifts, half of them done before implementing the new handover method, with a focus on the percentages of operational issues mentioned using the two different systems.  It noticed a marked increase in these with the new system.

Length of publication:  1 web page

Some important notes:  This article is available in full text to all NHS Staff using Athens, for more information about accessing full text follow this link to find your local NHS Library


Digital doctors’ notes improve patient safety at Havering hospital

November 3, 2011

Source: Romford Recorder

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Date of publication: October 2011

Publication type: News item

In a nutshell: This news item looks at the innovative new system used at Havering’s hospital trust which recently won a national award for patient safety.  The eHandover system was introduced a year ago to increase the smooth running of handovers and ensure that all the necessary information was communicated.

Length of publication: 1 web page

Acknowledgement: Romford Recorder