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Prospective Observational Multisite Study of Handover in the Emergency Department: Theory versus Practice

INTRODUCTION: The handover process in the emergency department (ED) is relevant for patient outcomes and lays the foundation for adequate patient care. The aim of this study was to examine the current prehospital to ED handover practice with regard to content, structure, and scope. METHODS: We carri...

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Autores principales: Ehlers, Philipp, Seidel, Matthias, Schacher, Sylvia, Pin, Martin, Fimmers, Rolf, Kogej, Monika, Gräff, Ingo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972381/
https://www.ncbi.nlm.nih.gov/pubmed/33856332
http://dx.doi.org/10.5811/westjem.2020.9.47836
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author Ehlers, Philipp
Seidel, Matthias
Schacher, Sylvia
Pin, Martin
Fimmers, Rolf
Kogej, Monika
Gräff, Ingo
author_facet Ehlers, Philipp
Seidel, Matthias
Schacher, Sylvia
Pin, Martin
Fimmers, Rolf
Kogej, Monika
Gräff, Ingo
author_sort Ehlers, Philipp
collection PubMed
description INTRODUCTION: The handover process in the emergency department (ED) is relevant for patient outcomes and lays the foundation for adequate patient care. The aim of this study was to examine the current prehospital to ED handover practice with regard to content, structure, and scope. METHODS: We carried out a prospective, multicenter observational study using a specifically developed checklist. The steps of the handover process in the ED were documented in relation to qualification of the emergency medical services (EMS) staff, disease severity, injury patterns, and treatment priority. RESULTS: We documented and evaluated 721 handovers based on the checklist. According to ISBAR (Identification, Situation, Background, Assessment, Recommendation), MIST (Mechanism, Injuries, Signs/Symptoms, Treatment), and BAUM (Situation [German: Bestand], Anamnesis, Examination [German: Untersuchung], Measures), almost all handovers showed a deficit in structure and scope (99.4%). The age of the patient was reported 339 times (47.0%) at the time of handover. The time of the emergency onset was reported in 272 cases (37.7%). The following vital signs were transferred more frequently for resuscitation room patients than for treatment room patients: blood pressure (BP)/(all comparisons p < 0.05), heart rate (HR), oxygen saturation (SpO(2)) and Glasgow Coma Scale (GCS). Physicians transmitted these vital signs more frequently than paramedics BP, HR, SpO(2), and GCS. A handover with a complete ABCDE algorithm (Airway, Breathing, Circulation, Disability, Environment/Exposure) took place only 31 times (4.3%). There was a significant difference between the occupational groups (p < 0.05). CONCLUSION: Despite many studies on handover standardization, there is a remarkable inconsistency in the transfer of information. A “hand-off bundle” must be created to standardize the handover process, consisting of a uniform mnemonic accompanied by education of staff, training, and an audit process.
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spelling pubmed-79723812021-03-23 Prospective Observational Multisite Study of Handover in the Emergency Department: Theory versus Practice Ehlers, Philipp Seidel, Matthias Schacher, Sylvia Pin, Martin Fimmers, Rolf Kogej, Monika Gräff, Ingo West J Emerg Med Emergency Department Operations INTRODUCTION: The handover process in the emergency department (ED) is relevant for patient outcomes and lays the foundation for adequate patient care. The aim of this study was to examine the current prehospital to ED handover practice with regard to content, structure, and scope. METHODS: We carried out a prospective, multicenter observational study using a specifically developed checklist. The steps of the handover process in the ED were documented in relation to qualification of the emergency medical services (EMS) staff, disease severity, injury patterns, and treatment priority. RESULTS: We documented and evaluated 721 handovers based on the checklist. According to ISBAR (Identification, Situation, Background, Assessment, Recommendation), MIST (Mechanism, Injuries, Signs/Symptoms, Treatment), and BAUM (Situation [German: Bestand], Anamnesis, Examination [German: Untersuchung], Measures), almost all handovers showed a deficit in structure and scope (99.4%). The age of the patient was reported 339 times (47.0%) at the time of handover. The time of the emergency onset was reported in 272 cases (37.7%). The following vital signs were transferred more frequently for resuscitation room patients than for treatment room patients: blood pressure (BP)/(all comparisons p < 0.05), heart rate (HR), oxygen saturation (SpO(2)) and Glasgow Coma Scale (GCS). Physicians transmitted these vital signs more frequently than paramedics BP, HR, SpO(2), and GCS. A handover with a complete ABCDE algorithm (Airway, Breathing, Circulation, Disability, Environment/Exposure) took place only 31 times (4.3%). There was a significant difference between the occupational groups (p < 0.05). CONCLUSION: Despite many studies on handover standardization, there is a remarkable inconsistency in the transfer of information. A “hand-off bundle” must be created to standardize the handover process, consisting of a uniform mnemonic accompanied by education of staff, training, and an audit process. Department of Emergency Medicine, University of California, Irvine School of Medicine 2021-03 2021-01-12 /pmc/articles/PMC7972381/ /pubmed/33856332 http://dx.doi.org/10.5811/westjem.2020.9.47836 Text en Copyright: © 2021 Ehlers et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/
spellingShingle Emergency Department Operations
Ehlers, Philipp
Seidel, Matthias
Schacher, Sylvia
Pin, Martin
Fimmers, Rolf
Kogej, Monika
Gräff, Ingo
Prospective Observational Multisite Study of Handover in the Emergency Department: Theory versus Practice
title Prospective Observational Multisite Study of Handover in the Emergency Department: Theory versus Practice
title_full Prospective Observational Multisite Study of Handover in the Emergency Department: Theory versus Practice
title_fullStr Prospective Observational Multisite Study of Handover in the Emergency Department: Theory versus Practice
title_full_unstemmed Prospective Observational Multisite Study of Handover in the Emergency Department: Theory versus Practice
title_short Prospective Observational Multisite Study of Handover in the Emergency Department: Theory versus Practice
title_sort prospective observational multisite study of handover in the emergency department: theory versus practice
topic Emergency Department Operations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972381/
https://www.ncbi.nlm.nih.gov/pubmed/33856332
http://dx.doi.org/10.5811/westjem.2020.9.47836
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