Abstract
The paper presents the results of a qualitative study investigating safety of patient handover in the emergency care pathway. Semi-structured interviews were conducted with 39 practitioners from two NHS ambulance services and three hospitals in England. Thematic analysis identified two main themes: (1) there are tensions in the activity of handover, which practitioners deal with by making dynamic trade-offs based on their expertise and depending on the particular situation; (2) the management of patient and information flows across organisational boundaries is a key factor affecting the quality and safety of handover. The results suggest that there is a need for greater collaboration across organisational boundaries, and that organisational policies and procedures should provide flexibility to practitioners enabling them to make necessary local trade-offs based on their expertise
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