Article 2 A STANDARDIZED PATIENT HANDOVER PROCESS: PERCEPTIONS AND FUNCTIONING KARINA AASE Department of Health Studies, University of Stavanger ELSA SØYLAND Stavanger Acute Medicine Foundation for Education and Research BRITT SÆTRE HANSEN Intensive Care Unit, Stavanger University Hospital ABSTRACT In this paper, we describe the perceptions and functioning of a standardized patient handover protocol to improve communication between ambulance personnel and emergency department (ED) nurses in the transition between pre-hospital and in-hospital care. Patient handovers are identified as a vulnerable step in safe patient care due to the fact that vital patient information may get lost or misinterpreted. An exploratory research design with multistage focus group interviews was chosen to study a standardized handover protocol across two different disciplines two years after the implementation of the protocol. Study results reveal that even though both ambulance personnel and ED nurses are more content with the information flow and the dialogue than prior to the protocol, there are still challenges related to communication and information exchange, to the system surrounding the handover process, to attitudes towards the usefulness of formalized protocols, and to the knowledge of the handover protocol in itself. 1. INTRODUCTION The primary objective of a ‘handover’ is to provide accurate information about a patient’s care, treatment and services, current condition and any recent or anticipated changes (www.handover.eu, Watcher 2008). Interest in handovers has grown steadily over the past decade as researchers, hospital administrators, educators, and policy makers have learned that current handover processes are highly variable and potentially unreliable (Manser & Foster 2011). Thus, in 2007 effective communication during handover was listed one of the National Patient Safety Goals by the Joint Commission on Accreditation of Healthcare Organisations (JCAHO 2007) and is today one of the five solution areas of the “High 5s initiative” established by WHO and the Commonwealth Fund (www.high5s.org). Transitions in patient care due to a handover by the care provider/team to another provider/team can have detrimental effects on the quality and safety of patient care. During the past several years, we have seen transitions in care become more frequent, resulting in increased opportunities for errors that may result in patient harm (Cheah 2005, Arora & Johnsen 2006, Sharit et al 2005, LaMantia et al 2010). Patient handover in the emergency department (ED) is mainly a two-way communication process between ambulance personnel and ED staff where information exchange is crucial for the transfer from pre-hospital to in- hospital care. The handover process with belonging reporting routines thus plays a key role in securing continuity, quality, and safety in patient health care (Jenkin et al 2007). Yet, there is little guidance from the literature on how to best exchange information. Information transfers (handovers) are a recognized vulnerability for medical errors (Arora & Johnson 2006). Studies suggest that handovers are often characterized by communication failures and Issue 2 2011 V V O O L L 1 1 5 5