Clinical Handovers - What Are They And How To Make Them Easier

A clinical handover refers to the transfer of some or all parts of a patient’s care to a new healthcare provider. Patients are often transferred between healthcare providers during their treatment, so understanding the strategies you can employ to optimize this process will guarantee good continuity of care. Unfortunately, research tends to show that clinical handover is often riddled with mistakes, leading to poor care and errors in treatment decisions. When communication between responsible healthcare providers is inefficient, patients can suffer adverse consequences. Whilst these situations are understandable given the busy schedules of most practitioners and increases in service demands, efforts should consistently be made to avoid them. 

Improvements in clinical handovers will lead to the accurate and efficient transmission of information, facilitating higher chances of good patient outcomes. But how exactly can these handovers be improved? One of the most common focuses of practices looking to improve their handovers relates to the production of clinical documentation. Many healthcare practices have begun to implement real-time clinical documentation systems that facilitate accurate documentation and consequently lead to more effective communication between healthcare providers.

The healthcare industry is moving away from the notion of a sole healthcare provider, and instead frames the care of a patient in the context of a healthcare team. This change has made it more important now than ever that communication between different providers, including doctors and nurses, is constant and effective. Effective clinical handovers will indicate to providers whether they need to make new treatment decisions, debrief their patients, present follow-up results, or generate referrals. Because all of this information should be included within clinical documentation, the process of writing notes and updating medical records should be the main priority for healthcare practices. Implementing healthcare software is one of the most efficient methods of improving clinical documentation. These systems offer providers templates for various types of clinical notes, as well as real-time storage capabilities. This way, every provider that is an authorized user has 24/7 access to the relevant patient information, facilitating a seamless clinical handover. With a sophisticated system, your practice can streamline its handover process by significantly simplifying clinical documentation.

Whether you are a seasoned professional or just beginning your career as a healthcare practitioner, it is inevitable that mistakes will be made during a handover process. Research conducted on the most frequently occurring challenges related to clinical handovers focused largely on errors in communication. Communication inefficiencies were often related to a lack of detail transmitted between the outgoing nurse and the incoming nurse. Often, facts regarding the patient’s health condition are transferred, but there is limited discussion of less technical interactions that occurred during the shift. Although these aspects may seem less important, they help to provide a more holistic understanding of the patient’s current status. Further, by detailing interpersonal interactions and behaviors, the incoming nurse can facilitate a better relationship with the patient and help ensure they are comfortable and confident with the change in care.

Another challenge that often impacts the clinical handover process is the absence of recorded information. Even if the outgoing nurse has an effective conversation with the incoming nurse, this information still needs to be recorded. Expecting the incoming nurse to retain all verbally received information is unrealistic, and they need to be supported by recorded documents. Using online clinical documentation systems can help guarantee these notes are effective and consistent, with the additional advantage of being accessible to providers 24/7.

The importance of making the clinical handover process as efficient and effective as possible is clear, but how exactly can you make this happen? Fortunately, improving your clinical notes and documentation handover isn’t overly complicated, and we have formulated some useful strategies to help you with this process:

• Spend time on the handover interaction: It is often thought that lengthy interactions during the handover process are an inefficient use of time. However, it is critical that both patients and providers feel as though they can ask questions or raise concerns in order to guarantee all parties are adequately aware of the situation. As such, an effective handover is reliant upon thorough interactions, no matter how much time it takes.
• Standardized protocols: After research revealed the extent of communication errors that occur during the handover process, standardized protocols were introduced to many practices. These protocols minimize confusion and interruption and help ensure the provider structures the relevant information in a meaningful way. You could also choose to introduce a checklist during the handover process. This means that you don’t have to learn a new protocol, but are still assisted by a useful document that will guarantee you cover all the important information. 
• External hospital factors: It is often the case that external factors within the hospital negatively affect the handover process. These factors may include time allocation, available resources, physical location, and external noise. Minimizing potential distractions will enable providers to communicate in a more effective and efficient manner. 
• Patient involvement: As the healthcare industry increasingly embraces the concept of customer-based care, it has become more important to engage the patient in the handover process. Not only does this mean that they should be present during the interaction, but they should feel comfortable enough to ask the provider questions or raise any concerns. Patients want a role to play in managing their own care, which can be assisted by making the handover process as transparent as possible.
• Training: Regardless of the experience of a healthcare professional, training staff will always have positive consequences. Most of the time, miscommunication and errors that occur during handover are a result of a lack of knowledge and awareness. The vast majority of poor treatment outcomes during handover are entirely avoidable, and as soon as providers are aware of this, preventative efforts can be made. Implementing a training session that is educational and informative will help improve the effectiveness of the handovers in your clinic. 

Final thoughts

Clinical handovers are a frequent occurrence during the treatment process of a patient in care. As healthcare practices are having to deal with a higher influx of patients, managing the handover is often pushed to the side. However, research has begun to point out that poor handovers can lead to extremely negative consequences for the patient, making it more important than ever to focus on improving these processes. Although your practice may have its own methods of managing handovers, we hope this article has provided you with some strategies that will elevate communication and improve clinical outcomes.

Further Reading:

• One chance to get it right: improving clinical handovers for better symptom control at the end of life‍
• Clinical handover in a bilingual setting: interpretative phenomenological analysis to exploring translanguaging practices for effective communication among hospital staff