Improving measurement in clinical handover.
BACKGROUND
Poor clinical handover creates discontinuities in care leading to patient harm. However, the field of handover research continues to lack standardised definitions and reliable measurement tools to identify factors that would lead to harm reduction and improved safety strategies.


OBJECTIVE
This paper introduces a conceptual framework to underpin a research agenda around the important patient safety topic of clinical handover.


METHODS
Five frameworks with potential application to clinical handover were identified in a consultation process with clinicians, researchers and policy makers.


RESULTS
The framework consists of three key handover elements-information, responsibility and/or accountability and system-in relation to three key measurement elements-policy, practice and evaluation. Using this framework an analysis of current "gaps" in the measurement of handover was completed.


CONCLUSIONS
The paper argues that measurement will identify gaps in knowledge about handover practice and promote rigor in the design and evaluation of interventions to reduce patient harm.
Jeffcott
S A
SA
NHMRC Centre for Research Excellence in Patient Safety, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. shelly.jeffcott@med.monash.edu.au
Evans
S M
SM
Cameron
P A
PA
Chin
G S M
GS
Ibrahim
J E
JE
D002983:Clinical Competence; D003266:Continuity of Patient Care / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D007400:Interprofessional Relations; D019300:Medical Errors / Q000517:prevention & control; D015279:Organizational Culture; D010348:Patient Care Team / Q000458:organization & administration*; D017064:Process Assessment, Health Care; D011640:Public Policy; D011787:Quality of Health Care / Q000458:organization & administration*; D017751:Safety Management / Q000458:organization & administration*