Clinical Handover Practice in the Emergency and Trauma Department of SASMEC@IIUM: An Observational Qualitative Study.

Abstract

Introduction: Clinical handover is a critical nature of communication between the staff, given it physicians, nurses or even the assistant medical officer. Specifically, in Emergency and Trauma Department(ETD) where turnover of patients is high in a fast-paced environment with unpredictable events, the tendency of communication failure and errors increased. In ensuring safety and efficient clinical handover practice, demands critical information that needed to be informed when communicate between the shifts or the staff. Therefore, this study mainly to identify the best way of clinical handover that would assist in better communication amongst emergency healthcare providers as well as within different departments. Objective: To examine the current shift handover practices amongst emergency staff at SASMEC@IIUM, identify the resources and supports to enhance clinical handover effectiveness and to determine the barriers and facilitators on the effectiveness of clinical handover. Methodology and Methods: A descriptive, qualitative study was conducted by selecting samples through purposive sampling technique. Nurses, physicians and assistant medical officers were selected in this study. The sample size was determined using the ‘saturation criterion’. Topic guide interview has been selected for the participants to share their opinions, suggestions, and experiences. Open-ended questions have been used to identify the participants’ perspectives towards the current practices of clinical handover in Emergency and Trauma Department of SASMEC. Data were then analysed using thematic analysis and later developed into sub-themes and themes. Findings: Six themes were identified for this study which consist of 1) learning methods of clinical handover, 2) information passed to next shift, 3) information expected to receive, 4) opinions on current handover, 5) handover effectiveness 6) suggestions for improvement. The themes described mostly on the experiences, opinions and suggestions from the healthcare professionals working in the Emergency and Trauma Department of SASMEC. Conclusion: This study found that the healthcare providers in ETD have various backgrounds of learning clinical handover, with some of them have different working experiences since they worked in other hospitals, departments, or settings previously. In addition, they also described their own experiences in handling clinical handover in ETD SASMEC, together with the factors that affect the effectiveness of the clinical handover process. Besides, the findings were also concentrated on the elements that the participants assumed may be beneficial for the improvement of clinical handover overall that could be done in future. Keywords: Clinical handover, Practice, Emergency Department, Qualitative, Malaysia