An inquiry into the perceived clinical handover of patients arriving in a large tertiary care emergency department

Abstract

Background: Delays in clinical handover can compromise a patient's care. The handover is not the sole responsibility of the ambulance personnel or the emergency departments. Reducing delays requires the working together of the entire organization, as well as designing efficient emergency and ambulance departments. Objectives: The study aims at exploring the quality of clinical handover between the emergency department personnel and the ambulance personnel at Hamad General Hospital. Methods: This is a descriptive study using two kinds of anonymous questionnaire surveys to gauge the current opinion regarding patient handover. One was aimed at physicians, who are the hospital employees, and the second was intended for the ambulance personnel. The employees of the Emergency Department were asked to provide their opinion of the handovers that the ambulance employees provided in a given clinical situation. The clinical situations in question included: cardiac arrest, pediatric emergencies, sepsis, chest pain, head injury, and trauma. Results: A total of 65 ambulance employees and 70 medical employees completed the survey. The findings of the study indicate that there is a formal training procedure for patient handover, and that, in general, the quality of communication of history, the general quality of handover, and the knowledge of vital signs reported were high. The ambulance personnel were satisfied with their quality of handover. However, the medical staff were less positive, particularly for sepsis and pediatric emergencies. The findings also indicate that the ambulance employees perceived a high level of delay regarding patient handover. Conclusions: It was encouraging that both groups had a positive perception about the handover. The areas for improvement identified by the medical employees were sepsis and pediatric emergencies, while the ambulance employees perceived a significant delay in the handover. In conclusion, the study proposes the following recommendations as possible solutions: interdisciplinary training, addressing organizational culture, and flexibility in organizational processes.