Problems in handovers between doctors

• Main Author: Wee, Su Ern.
• Other Authors: School of Mechanical and Aerospace Engineering
• Format: Final Year Project
• Language: English
• Published: 2010
• Subjects: DRNTU::Engineering::Industrial engineering::Human factors engineering
• Online Access: http://hdl.handle.net/10356/40657
• Institution: Nanyang Technological University

This study aims to understand the current clinical handover process using the Department of Medicine of National University Hospital as a model. 24 medical officers (MOs) participated in interviews and shadowing whereby their handover calls were recorded using a smart phone and a researcher follows the medical officer on call, taking note of any observations. It is found that the handovers lack structure, most MOs depended on their memory when handover over patients. However, some of them refer to the Computerised Patient Support System (CPSS) or patient case notes as memory aids. From the 30 random samples that were taken, it is found that the 4 categories of tasks required to be performed are review sick patient, trace important lab results, trace blue letter replies and others. Majority of MOs perceived reviewing sick patients as most important and tracing investigation results could be done at a certain time or later. Ward/bed number of the patient is written down all the time by MO3, followed by task to do. However, apart from the background of the outgoing MO, which is not written down at all, the other information were written down by MO3 two-third of the time. But it was discovered that the amount of information discussed during a handover did not affect the quality of the handover. Most of the time, handover calls came in when MO3 is engaged in other activities, these activities as well as the environment could be considered noise, a possible distraction to MO3 and reduces the clarity of the handover. Convenience is the main strength of the current handover method, followed by having room for clarifications. However, MOs might be pressurized to end a call quickly when there is an overload of calls. In addition, the current method lacks proper documentation and is subjected to the professional judgment of the medical officer.