Sunday, 6 July 2014

Rubbish Handovers

Doctors are often slated for their terrible handovers between shifts.  Whilst nurses have a rigid formal handovers at every shift change, we have formal handovers between SOME shifts but informal between others (for example the day doctor may bleep the twilight doctor with something that is yet to happen such as blood coming back, this is often quite haphazard. The twilight doctor will then formally handover at the end of their shift in a sit down meeting to the team of doctors on overnight including senior doctors.  I've noticed Often the very minimal change of sitting down and having someone senior present improves the quality of the handover and how much information is given.  However the twilight doctor may be handing over stuff from the day teams list so their handover will be limited by what the day team originally told them.)

Here's a handover I recieved this weekend:

Night shift doctor :  Oh and Mr Y hasn't had his xray yet.
Me: What is the xray for?
Night doctor: Not sure
Me: ... What type of xray
Night doctor: Oh erm Chest xray.
Me: Ok can I have his hospital number
Night doctors: (Has this and gives it to me but only after I ask)

I later hunt down Mr Y's request form purely so that I can find out why he is having one.  At this point I discover its not  a chest xray but a lower leg (fairly different ends of the body!) and he is having for the potentially very serious issue of ?osteomyelitis (infection of the bone). So I was very glad I looked!

I received this handover at a formal type handover so perhaps sitting down doesn't always solve "medical-chinese-whispers" after all.  In summary, we as profession do need to work on our handovers.  (This example is the worst I can think of but there are plenty of other slightly rubbish ones).  This weekend has reminded me about the importance of trying to both handover well and make sure I ask the right questions of those handing over to me so that I know what is going on.  Geeky though it is I recommend all those reading this try to remember to do their handovers in a formulalic way such as the "SBAR" system.

Happy handing over!!

Halfadoc x


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  2. Handovers are high-risk points in patient care.