3.3 CHARACTERISTICS OF HANDOVER
Laxmisan et al (2007) conducted an ethnographic study involving analysis of emergency department handover in a US hospital. The study found that interruptions within the emergency department were prevalent and diverse in nature and that there were gaps in information flow due to multi-tasking and shift changes. The communication process is complex and cognitively taxing during and after team handover, that can compromise patient safety. The study also discusses the need to tailor generic electronic tools to support adaptive processes like multi-tasking and handoffs in time constrained environments. Arora et al (2005) conducted interviews using the critical incident technique to handover failures between inpatient physicians in a US hospital. The study interviewed 26 interns and found 25 discrete incidents. The 21 worst events are described. Omitted contents and failure prone communication processes were identified as a major category of failure in communication. These may result in inefficient or sub-optimal care, leading to patient harm.
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The study found that each type of handover had its own strengths and weaknesses. The effectiveness of each type of handover remained unclear and no one type was appraised as being more effective. The study recommends taking into account the socio-cultural context of handover and exploring more creative ways to conduct handovers to ensure it fulfils its multiple