Clinical handover

Clinical handover (patient handover or handover) is the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person or professional group on a temporary or permanent basis.[1]

When critical clinical information emerges or there is a risk to patient care, timely communication of this information to the appropriate person(s) is essential to ensuring patient safety and delivery of the right care. Failure in handover is a major source in preventable patient harm. Clinical handover is an international concern and Australia, the United Kingdom and other countries have developed risk reduction recommendations.[1]

It is important to define and agree on the minimum information content for clinical handovers relevant to a service or discipline. It may be helpful to consider what clinical and non-clinical information is time critical or significant to patient care, such as:[2]

• New critical diagnostic or test results that require a change to care
• Changes in a patient’s physical and psychological condition, including unexpected deterioration or development of complications
• Follow-up communication following a review of results.

Use of structured handover tools can help to provide a framework for communicating the minimum information content for clinical handovers. This may be supported by electronic clinical handover templates.[3]

Examples of clinical handover tools to help structure handover:[2]

• ISBAR (Identify, Situation, Background, Assessment, Recommendation)
• SBAR (Situation, Background, Assessment, Recommendation)
• SHARED (Situation, History, Assessment, Risk, Expectation, Documentation)
• I PASS the BATON (Introduction, Patient, Assessment, Situation, Safety concerns, Background, Actions, Timing, Ownership, Next).