Creating Safe Handover Systems In Pre-Hospital Care

Handover comprises the transfer of patient care, responsibility and accountability between health care professionals. Across Scotland physician led prehospital critical care teams (PHCCT) have been introduced to support paramedics deliver life-saving care to improve patient survival. But often PHCCT’s arrive after the paramedics and so ‘patient handover’ is necessary. Although little is known about handover in this environment research on in-hospital handover report this to be a high-risk, potentially harmful process for patients. Studies on the handover between paramedics and Emergency Department (ED) staff have highlighted significant challenges in this area too and so these are likely to be replicated and amplified in the uncontrolled pre-hospital setting. We will use routinely recorded video footage of prehospital handovers to observe and systematically study quality and safety markers, undertake interviews with PHCCT's and paramedics to identify barriers to effective handover and then co-develop an intervention to make future handover practices safer.