UNCONTROLLED WHEN PRINTED

Purpose

  • The purpose of this document is to standardise the clinical handover process to ensure that handovers initiated by St John Ambulance WA staff are safe, appropriate and evidence-based. Standardisation of handover, as part of a comprehensive, system-wide strategy, will aid effective, concise and inclusive clinical communication in all clinical situations and contribute to improved patient safety1.
  • This document is designed in reference to the WA Health Clinical Handover Policy and outlines the minimum set of requirements for all types of handover involving the transfer of patient care.

Definitions

  • Clinical 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 basis2.

Scope

  • This process applies to anyone providing health services on behalf of St John Ambulance WA. It applies in all circumstances where a clinical handover is required. Please refer to the relevant document for Interfacility Transfers.

Communicating for Safety Standard

  • Communication is a key safety and quality issue3. To align with the National Safety and Quality Health Service Standards, St John have implemented this document to achieve effective, high quality communication of relevant clinical information that is understood and accepted by the receiver when responsibility for patient care is transferred1.

Communication at clinical handover

  • Handover content should be clear, concise, and use easily understood words with minimal, accepted, abbreviations. Within WA health, the standardised structure for all clinical handovers is iSoBAR. This structure should be adopted for all patient handovers.
IIdentityName, Age, Gender, Date of Birth
SSituationBriefly describe the presenting complaint
OObservationsRelevant and multiple trended recent vital signs
BBackgroundHistory relevant to the presenting complaint/injury and mechanism,
medications and medical history
AAssessment and actionAssessments, interventions and response to treatment
RRead backRead back of critical information
Clarify and check for shared understanding

Patients of concern

  • Patients should be handed over in accordance with their severity and clinical risk, as determined by a treating clinician1.
  • Management of a deteriorating patient must be escalated as soon as deterioration in a patient’s condition is detected1.
  • Handover of patients of concern must be documented1.

Handover between higher skill level to lower skill level

  • Clinical staff may encounter circumstances when it may be necessary to handover care of patients in the community to officers of a lower skill level (e.g. Paramedic to EMT, CCP to Paramedic). Such circumstances may include situations such as multiple patients, mass casualty situations or circumstances where the higher level crew is unable to continue provision of care. In the absence of special circumstances the higher level crew/clinical officer are to remain as the primary patient care provider until handover of patient to a health facility or other service provider such as ERHS or RFDS.
  • The caregiver must handover all components of care that have been commenced and provided. All information and a care plan should be discussed and documented which outlines any reasonably foreseeable deterioration or side effects of care that has commenced. Paramedics are reminded that once a decision is made to hand a patient over to a crew which is a step down in care, the paramedic carries some responsibility for the outcome of the patient until handover to definitive care for any issues that could have been reasonably foreseen.

Documentation

  • All handovers must be supported by a patient care record completed in accordance with the relevant policy.

 


References
References

Key Terms & Links

Associated guideline: Interfacillty, General and Mental Health Transfers policy.

  1. WA Health Clinical Handover Policy, November 2013. Perth: Department of Health, WA.
  2. Australian Medical Association. Safe handover: safe patients. Guidance on clinical handover for clinicians and managers. Canberra: Australian Medical Association; 2006.
  3. Australian Commission on Safety and Quality in Health Care. National Safety and Quality Health Service Standards. 2nd ed. Sydney: ACSQHC; 2017.

Document Control


Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

Date

Review Date

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