Junior residents' experience and perception of handover: Implications on developing a standard handover protocol and handover training

Abstract

Poor handovers contribute to medical near misses, adverse events and waste of healthcare resources. To improve handover communication, public hospitals in Singapore are among the pioneers in Asia to develop standardized handover protocols and handover training courses. This study aimed to examine junior residents’ experience and perception on clinical handovers and discuss the implications on developing a standard handover protocol and handover training. Two survey studies with 47 junior residents were conducted at the Department of Internal Medicine, National University Hospital (NUH) of Singapore in Nov 2008 and from Jan to Mar 2010 respectively. Overall, junior residents supported handover standardization. Specifically, with respect to content standardization, junior residents demonstrated a good awareness of essential topics that should be communicated during a handover, and yet follow up action and non-modifiable identifiers were poorly covered in their current practices; with respect to method standardization, they showed a strong preference for an interactive handover channel. To our surprises, the recommended verbal communication plus text message method was not highly accepted, largely due to the high workload of preparing text messages. Moreover, handover training was advocated by junior residents and they considered the early stage of physicians’ medical training to be the proper time to learn handover skills.