title: Clinical handover of patients arriving by ambulance to the emergency department - a literature review.
abstract: OBJECTIVE
  To provide a critical review of research on clinical handover between the ambulance service and emergency department (ED) in hospitals.
  
  
  METHODS
  Data base and hand searches were conducted using the keywords ambulance, handover, handoff, emergency department, emergency room, ER, communication, and clinical handover. Data were extracted, summarised and critically assessed to provide evidence of current clinical handover processes.
  
  
  RESULTS
  From 252 documents, eight studies fitted the inclusion criteria of clinical handover and the ambulance to ED patient transfer. Three themes were identified in the review: (1) important information may be missed during clinical handover; (2) structured handovers that include both written and verbal components may improve information exchange; (3) multidisciplinary education about the clinical handover process may encourage teamwork, a shared common language and a framework for minimum patient information to be transferred from the ambulance service to the hospital ED.
  
  
  CONCLUSIONS
  Knowledge gaps exist concerning handover information, consequences of poor handover, transfer of responsibility, staff perception of handovers, staff training and evaluation of recommended strategies to improve clinical handover. Evidence of strategies being implemented and further research is required to examine the ongoing effects of implementing the strategies.
authors.affiliation: Gold Coast Hospital & Griffith University, Emergency Department, Southport 4215 QLD, Australia. nerolie_bost@health.qld.gov.au
authors.forename: Nerolie
authors.initials: N
authors.lastname: Bost
authors.forename: Julia
authors.initials: J
authors.lastname: Crilly
authors.forename: Marianne
authors.initials: M
authors.lastname: Wallis
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Patterson
authors.forename: Wendy
authors.initials: W
authors.lastname: Chaboyer
mesh_terms: D000552:Ambulances / Q000458:organization & administration; D001291:Attitude of Health Personnel; D003142:Communication; D003266:Continuity of Patient Care; D016529:Emergency Nursing / Q000193:education / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000458:organization & administration; D055317:Evidence-Based Practice; D006301:Health Services Needs and Demand; D006801:Humans; D007400:Interprofessional Relations; D016294:Models, Nursing; D017146:Models, Organizational; D015403:Nursing Evaluation Research; D010348:Patient Care Team / Q000458:organization & administration; D010360:Patient Transfer / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D056164:Teaching Rounds / Q000458:organization & administration*; D017749:Total Quality Management