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Maximising learning opportunities in handover
  1. R E Klaber1,2,
  2. C F Macdougall3
  1. 1
    Department of Paediatrics, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
  2. 2
    London Specialty School of Paediatrics and Child Health, London, UK
  3. 3
    Warwick Medical School and University Hospital, Coventry, UK
  1. Dr R E Klaber, Department of Paediatrics, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK; bobklaber{at}doctors.org.uk

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Handing over responsibility for patients has always been part of medical practice. Definitions emphasise transfer of responsibility to ensure patient safety and the available literature tends to follow this line (see box 1). Handover is much more than this, however. It is a key event where teams meet, have the opportunity to communicate, support each other and learn. This paper considers different ways of maximising learning opportunities in handover, with particular emphasis on the strengths and challenges of the paediatric environment. Alongside review of the best available evidence, many of the ideas discussed were generated from working with a group of 65 experienced paediatricians with particular experience and interest in medical education as part of the Royal College of Paediatrics and Child Health Paediatric Educators Programme.

Formal handover has increased in importance and been embedded in practice with the transition from “on-calls” to “full-shift” rotas in an effort to comply with the European Working Time Directive1 in the United Kingdom (UK). Departments responsible for acute patient care have had to incorporate two or three handover sessions into every day to ensure patient problems and management plans are appreciated by the incoming medical team.

Box 1 Definition of “handover”

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” (The National Patient Safety Agency2).

Surveys have been conducted to look at handover practices24 and to consider how changes, perceived to improve practice, can be implemented. It is widely acknowledged that the primary aim of handover is to ensure effective continuity of care for patients, and a number of guidelines and frameworks have been published to promote this.510 The focus is mainly on …

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