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- Title
Conceptualizing handover strategies at change of shift in the emergency department: a grounded theory study.
- Authors
Lawrence RH; Tomolo AM; Garlisi AP; Aron DC; Lawrence, Renée H; Tomolo, Anne M; Garlisi, Andy P; Aron, David C
- Abstract
<bold>Background: </bold>The importance and complexity of handovers is well-established. Progress for intervening in the emergency department change of shift handovers may be hampered by lack of a conceptual framework. The objectives were to gain a better understanding of strategies used for change of shift handovers in an emergency care setting and to further expand current understanding and conceptualizations.<bold>Methods: </bold>Observations, open-ended questions and interviews about handover strategies were collected at a Veteran's Health Administration Medical Center in the United States. All relevant staff in the emergency department was observed; 31 completed open-ended surveys; 10 completed in-depth interviews. The main variables of interest were strategies used for handovers at change of shift and obstacles to smooth handovers.<bold>Results: </bold>Of 21 previously identified strategies, 8 were used consistently, 4 were never used, and 9 were used occasionally. Our data support ten additional strategies. Four agent types and 6 phases of the process were identified via grounded theory analysis. Six general themes or clusters emerged covering factors that intersect to define the degree of handover smoothness.<bold>Conclusion: </bold>Including phases and agents in conceptualizations of handovers can help target interventions to improve patient safety. The conceptual model also clarifies unique handover considerations for the emergency department setting.
- Publication
BMC Health Services Research, 2008, Vol 8, p256
- ISSN
1472-6963
- Publication type
journal article
- DOI
10.1186/1472-6963-8-256