Handover System Research Articles

Performance Evaluation of an Effective Mobility Model for D2D Communications

Device-to-Device (D2D) communication, in which devices take advantage of their physical proximity, becomes an emerging technology and a hot research area for 5G cellular networks. Many research works have thoroughly tried to deal with interference management, resource allocation, security, opportunistic device contacts and user mobility. However, unpredictable device mobility may influence the service continuity of a D2D communication. Therefore, the effects of the mobility model on D2D communication performances must be fully studied. In this paper, we adapt the RPGM (Reference Point Group Mobility), a group mobility model, to the D2D communication. It is suitable for modelling the D2D mobility and manages the relationship among mobile devices. To demonstrate the effectiveness of our adopted mobility model, we compare it to other popular mobility models. As expected, our adopted mobility model outperforms the other models in terms of handover latency and system performances with different D2D applications.

Effects of a stepwise handovers ISBARQ programme among nursing college students.

BackgroundDue to a lack of standardized guidelines, it is necessary to verify the effectiveness of educational programmes for nursing students' systematic handover training.AimsThis study aimed to develop a stepwise nursing handover programme and to examine its effects on awareness of handover Situation, Background, Assessment, Recommendation, communication self‐efficacy and satisfaction with handover education.DesignThis was a single‐group repeated measures ANOVA study.MethodsThis study was conducted in a nursing department, using a convenience sample of 25 senior nursing students from April 2 to June 22, 2018. The programme was divided into lectures, scenario role‐playing and nursing case role‐playing. The research questions were analysed using repeated measures ANOVA.ResultsAwareness of handover Situation, Background, Assessment, Recommendation, communication self‐efficacy and satisfaction with handover education gradually increased after each step of the programme. The stepwise nursing handover programme, progressing from low to high levels of learning, can be used to improve the nursing handover system and handover communication ability.

Weekend handover: Improving patient safety during weekend services

Clinical Handover has been identified as one of the most high-risk processes within medicine. Inadequate handover is a significant cause of avoidable adverse events across many hospitals. A likert-survey of the weekend handover system at a district general hospital demonstrated significant dissatisfaction amongst junior doctors. Intending to improve patient safety and reduce stress for on-call junior doctors, a weekend handover proforma was compiled according to the Royal College of Physicians and Surgeons guidelines. The proforma was trialed on six medical wards for six months with a before and after questionnaire being sent to doctors on the wards involved to determine the proforma’s merits on a scale of 1 (least effective) to 10 (most effective). Reports subsequent to implementation demonstrated a 67% increase ease of identifying outstanding weekend jobs. 57% of doctors reported better understanding of their patient’s diagnosis and management plan and 53% stated it was easier to identify the patients that required regular medical review over the weekend. Results also highlighted a 55% reported an increase in safety of weekend handovers (p<0.01). A closed loop audit of handover practice through the use of a standardised proforma showed improved quality, detail and consistency of handovers. The reduction in stress for junior doctors managing unknown patients with a clear concise plan, directed by a senior from the parent team during the week, has improved patient safety and doctor satisfaction.

Development and implementation of electronic medical handovers across psychiatric hospitals: quality improvement initiative

A lack of integration between internal processes and failure to use the full potential of information technology (IT) systems is common in psychiatric hospitals. We aimed to reduce the number...

Perceptions and Experiences of Hospital Nurses During Transition to an Electronic Handover Informatics System

An effective patient transfer, or handover, among healthcare professionals can help prevent communication-related medical errors, and a reliable electronic handover informatics system can standardize the handoff process. Adapting to a new handover system may cause stress for nurses. This descriptive qualitative study aimed to explore the perceptions and transition experiences of hospital nurses in adopting and adapting to a new handover informatics system. Thirty-eight nurses at a medical center in Taiwan participated in the study from December 2016 to January 2017. The researcher conducted five focus group interviews and analyzed all responses using content analysis. Results showed three major themes: "Perceptions of challenges and barriers related to the transition to a new handover informatics system," "Perceptions of benefits and strategies to the transition to a new handover informatics system," and "Suggestions for successful implementation of a new handover informatics system." Five subthemes emerged from the first theme, and six subthemes emerged from the second theme. The results of this study could enhance our understanding of nurses' perceptions and experiences with transition to a new handover informatics system and could provide a reference for hospitals to develop individualized strategies to facilitate the implementation of a handover informatics system.

Patient and healthcare provider knowledge, attitudes and barriers to handover and healthcare communication during chronic disease inpatient care in India: a qualitative exploratory study

Objectives1) To investigate patient and healthcare provider (HCP) knowledge, attitudes and barriers to handover and healthcare communication during inpatient care. 2) To explore potential interventions for improving the storage and...

The State-Owned Capital Gains Handover System and managerial agency cost: Evidence from central state-owned listed companies in China

We examine the effect of the State-owned Capital Gains Handover System on managerial agency cost among 382 Chinese central state-owned listed companies during 2004 to 2017. The results show that the State-owned Capital Gains Handover System has significantly positive effect on reducing managerial agency cost. That means a higher gain-handover proportion contributes to more effective corporate governance. However, the positive effect would become weaker with a company's stronger profitability. In addition, we examine the internal transferring mechanism of gain-handover pressure inside company groups. We find that the positive effect become stronger if the parent company's cash flow right is weaker. This research enriches the study on the gain-sharing relationships with a unique Chinese circumstance, the State-owned Capital Gains Handover System, and is of great importance for further improvement of this system and SOE reform.

Improving patient care by designing and implementing an electronic handover system

Improving patient care by designing and implementing an electronic handover system

The Impact of an Electronic Patient Bedside Observation and Handover System on Clinical Practice: Mixed-Methods Evaluation.

BackgroundPatient safety literature has long reported the need for early recognition of deteriorating patients. Early warning scores (EWSs) are commonly implemented as “track and trigger,” or rapid response systems for monitoring and early recognition of acute patient deterioration. This study presents a human factors evaluation of a hospital-wide transformation in practice, engendered by the deployment of an innovative electronic observations (eObs) and handover system. This technology enables real-time information processing at the patient’s bedside, improves visibility of patient data, and streamlines communication within clinical teams.ObjectiveThe aim of this study was to identify improvement and deterioration in workplace efficiency and quality of care resulting from the large-scale imposition of new technology.MethodsA total of 85 hours of direct structured observations of clinical staff were carried out before and after deployment. We conducted 40 interviews with a range of clinicians. A longitudinal analysis of critical care audit and electronically recorded patient safety incident reports was conducted. The study was undertaken in a large secondary-care facility in the United Kingdom.ResultsRoll-out of eObs was associated with approximately 10% reduction in total unplanned admissions to critical care units from eObs-equipped wards. Over time, staff appropriated the technology as a tool for communication, workload management, and improving awareness of team capacity. A negative factor was perceived as lack of engagement with the system by senior clinicians. Doctors spent less time in the office (68.7% to 25.6%). More time was spent at the nurses’ station (6.6% to 41.7%). Patient contact time was more than doubled (2.9% to 7.3%).ConclusionsSince deployment, clinicians have more time for patient care because of reduced time spent inputting and accessing data. The formation of a specialist clinical team to lead the roll-out was universally lauded as the reason for success. Staff valued the technology as a tool for managing workload and identified improved situational awareness as a key benefit. For future technology deployments, the staff requested more training preroll-out, in addition to engagement and support from senior clinicians.

MedE-Handover: Development of an electronic handover system to improve the safety and reliability of weekend handover on medical wards in a major acute teaching hospital

This project aimed to develop a robust and effective handover system to standardise the transfer of information between wards and out-of-hours clinicians, thus improving continuity of care and patient safety on medical wards. Electronic handover tools have been advocated as a potential strategy for enhancing the quality of handover. This project saw the design of a locally peer-reviewed Microsoft Excel database entitled ‘MedE-Handover’ which included scripts allowing semi-automation and standardisation of handover data. Replacing uncoordinated handwritten notes previously compiled separately by …

Reliable robotic handovers through tactile sensing

Joint manipulation and object exchange are common in many everyday scenarios. Although they are trivial tasks for humans, they are still very challenging for robots. Existing approaches for robot-to-human object handover assume that there is no fault during the transfer. However, unintentional perturbation forces can be occasionally applied to the object, resulting in the robot and the object being damaged, for example by being dropped. In this paper we present a novel approach to handover objects in a reliable manner while ensuring the safety of the robot and the object. Relying on tactile sensing, the system uses an effort controller to adapt the grasp forces in the presence of perturbations. Moreover, the proposed approach identifies a perturbation being applied on the object. When a perturbation event is detected, the algorithm classifies the direction of the pulling forces to decide whether to release it or not. The reliable handover system was implemented using a Shadow Robot hand equipped with BioTAC tactile sensors. Our results show that the system correctly adapts to the forces applied on the object to maintain the grasp and only releases the object if the human receiver pulls in the right direction.

An Electronic Handover System to Improve Information Transfer for Surgical Patients.

Proper clinical transfers of patient care (known as handovers) are important to patient safety. The aim of this study was to investigate the efficacy and satisfaction of an electronic system for clinical transfers of patients with complex surgical procedures. The design was a single-center observational study auditing the handover process. The electronic handover system combined with an electronic health record system was developed to help verbal handover. The system has a checklist to guide the structured handover process and provided information from the health record system. With the system, the elapsed time for surgical handover decreased from 10.5 to 5.4 minutes. The questionnaire analysis showed that clinician satisfaction with surgical handover increased from 69.4% to 79.3%, and the perception of communication completeness increased from 67.2% to 81.6%. The electronic handover system improved communication for the transfer of care for surgical patients.

Improving out-of-hours surgical patient care

PurposeThe Royal College of Surgeons recognises patient handover as the point at which patients are collectively at their most vulnerable. Concerns were raised in a London teaching hospital surgical department regarding an unstructured handover system, poor access to relevant clinical information, and inadequate weekend staffing. A quality improvement programme was designed and implemented to respond to these concerns and improve patient safety. The paper aims to discuss these issues.Design/methodology/approachA structured questionnaire was distributed to staff and results used to construct a diagram outlining the main factors influencing weekend patient safety. This framework was used to design changes, including a new electronic handover tool, regular handover meetings and additional weekend staff. Regular staff training was provided, and success was assessed in a continuous audit cycle with the results fed back to team leaders.FindingsOver a three-month period, the handover meeting recorded an attendance rate consistently above 80 per cent. The electronic handover entries were scored according to seven criteria (correct layout; key information, i.e.: patient location, clinical priority, active issues, resuscitation status, test results and weekend plan), averaging between 42.2 and 92.9 per cent, with progressive improvement seen over the assessment period. Weekend staffing was increased by 50 per cent, allowing a dedicated team to care for stable inpatients and to oversee discharges.Originality/valueThis improvement programme delivered lasting and significant change in response to staff concerns. It resulted in a more structured and reliable weekend system and established key mechanisms for dynamic performance feedback.

Failure Recovery in Robot–Human Object Handover

Object handover is a common physical interaction between humans. It is thus also of significant interest for human–robot interaction. In this paper, we are focused on robot-to-human object handover. The main challenge in this case is how to reduce the failure rate, i.e., to ensure that the object does not fall (object safety), while at the same time allowing the human to easily acquire the object (smoothness). To endow the robot with a failure recovery mechanism, we investigated how humans detect failure during the transfer phase of the handover. We conducted a human study that showed that a human giver primarily relies on vision rather than haptic sensing to detect the fall of the object. Motivated by this study, a robotic handover system is proposed that consists of a motion sensor attached to the robot's gripper, a force sensor at the base of the gripper, and a controller that is capable of regrasping the object if it starts falling. The proposed system is implemented on a Baxter robot and is shown to achieve a smooth and safe handover.

Implementing an electronic clinical handover system in a university teaching hospital.

Clinical handover is defined as inter-clinician communication occurring at care interfaces. In this study, we analyse the clinical outcomes and physician attitudes associated with the implementation of a electronic clinical handover system in our medical department. The aim of this project was to introduce a reliable, standardised, reproducible method of communicating information regarding inpatients within our medical department. We also sought to assess the attitudes of physicians within our department to medical handover. We designed and implemented an electronic handover template with a protocol to guide staff as to its use. Handover was audited weekly. In addition, we surveyed attitudes of doctors to handover before and after our handover pilot. An average of 32 patients were handed over each week. Compliance with mandatory handover of ICU/CCU patients averaged at 59%. Extrapolating our pilot results for the year would result in approximately 1655 handover events per annum in our department. One hundred percent of physicians surveyed felt that documentation of handover was beneficial, and staff satisfaction with handover improved after initiation of the pilot (81 vs 24%, p=0.000914). While 64% of staff were concerned that typed electronic handover would increase their workload, only 6% of the post pilot survey group felt that it did increase workload significantly. Electronic clinical handover is feasible and practical within the Irish healthcare system. In addition, it was found in our study to be attractive and effective to physicians without increasing their workload.

The use of Microsoft Excel as an electronic database for handover and coordination of patients with trauma in a District General Hospital

Communication between healthcare professionals is a key aspect in patient safety especially when dealing with patients with musculoskeletal trauma. The change of junior doctors’ working patterns within the last decade...

Improving patient safety: The impact of an outpatients' electronic handover system in a tertiary dermatology department.

Electronic medical records (EMR) can improve quality healthcare, patient safety and streamline workflow to improve efficiency of a department. Despite the known benefits and difficulties of EMR systems, there is limited data on the impact and definable effectiveness it can have within a dermatology unit. We present an outpatients' EMR known as an electronic handover system (EHS) from its inception, delivery and audit of its use in evaluating the true impact. An audit of the EHS was conducted from 1 March to 31 August 2014. Quantitative data evaluating the type of jobs entered and completed, overdue tasks, patient workload and phone consultations were conducted. Qualitative data was assessed via a pilot survey assessing users' perspectives of the EHS evaluating communication, clinician-patient relationship and administrative tasks. Altogether 754 jobs were entered for 411 dermatology outpatients using the EHS. Most tasks concerned following up bloods and swabs (38%) or biopsies (36%). Overall, 51 jobs were not completed by the specified due dates and 188 phone consultations were performed. Compared with pre-EHS data, clinic review patients fell by 16%, with a modest increase (2%) in the number of new patients seen. The survey results show that most respondents believed that EHS improved communication, did not affect the clinician-patient relationship and they were more confident in their practice knowing there was a recording system for follow up. The dermatology EHS has provided a reliable system for following up all outpatient results. The potential benefits range from clinical, organisational and health research, which, from our experience, demonstrates improved patient follow-up care.

Implementing an electronic patient handover system.

Clear communication among health-care teams is paramount for safe patient care and effective handover. Advances in information technology have led to an increased use of electronic systems within modern health care. This quality improvement project introduced an electronic patient handover system that was intended to improve the accuracy of patient handover lists and be readily available to all members of the health-care team. A quality improvement project was undertaken to assess the effect of introducing an electronic patient handover system on maintenance workload and list accuracy. List errors were common before the introduction of the electronic patient handover system, commonly patient location or a patient being incorrectly omitted from the list. These errors decreased significantly after the introduction of the electronic system (P<0.005 and 0.04 respectively). The workload associated with its maintenance also decreased (P<0.005) because many data fields were pre-populated by the software. This resulted in fewer instances of patients being missed on ward rounds (P<0.04). Through modifying existing information technology infrastructure, a centrally maintained, widely accessible electronic handover system was introduced. This reduced the workload associated with maintaining handover lists and the rate of errors.

Evaluation of a clinical handover simulation training session for junior doctors in psychiatry

BackgroundClinical handover is an important aspect of patient care and medical education, as identified by trainee surveys. There is a need for robust, standardised handover systems. Situation, Background, Assessment and...

Magnitude of non-operative surgical emergency admissions; service implications for surgical and radiological practice.

Financial sustainability is an area of sharp ongoing focus across the broad spectrum of the Irish Health Service. Recent attention has been drawn to the financial implications of non-operative surgical admissions, suggesting that some of these may be unnecessary. In this study, we aim to determine the volume of emergency surgical admissions to Mayo University Hospital (MUH), in particular, to identify the scale of non-operative admissions and to assess the wider inherent implications for acute hospital services. An electronic handover system for emergency surgical admissions was introduced in MUH in September 2014. All surgical admissions from September 1st 2014 to August 31st 2015 were identified from this prospectively maintained database. HIPE (Hospital Inpatient Enquiry) data were not used in this study. Theatre logbooks confirmed those patients who required operative intervention. 1466 patients were admitted as emergencies during the study period. 58% (850) were male and median age was 48years (0-100). Average length of stay was 5days (range 1-125). 327 patients (22.3%) required operative intervention. The most commonly performed procedure was appendicectomy (52.5%). 48 (3.3%) patients were transferred to other hospitals. 131 (8.9%) admissions related to the acute urological conditions. Of the 1466 admissions, 546 underwent a CT scan, while 342 patients proceeded to ultrasound. Almost 80% of all surgical emergency admissions were discharged without undergoing a formal operative procedure while generating a significant workload for the radiology department. Changes in working practices and hospital network structures will be required to reduce the burden of non-operative emergency admissions.