title: Cognitive support for a better handoff: does it improve the quality of medical communication at shift change in an emergency department?
abstract: OBJECTIVE
  To improve the communication during shift handover in an emergency department.
  
  
  METHODS
  We observed the handover process and analysed the discourse between physicians at shift change first, and then we created two cognitive tools and tested their clinical impact on the field. We used different measures to evaluate this impact on the health care process including the frequency and type of information content communicated between physicians, duration of the handoff, physician self-evaluation of the quality of the handoff and a posthandover study of patient handling.
  
  
  RESULTS
  Our results showed that the patient's medical history, significant test results, recommendations (treatment plan) and patient follow-up were communicated to a greater extent when the tools are used. We also found that physicians spent more time at the bedside and less time consulting medical records using these tools.
  
  
  CONCLUSIONS
  The present study showed how in-depth observations and analyses of real work processes can be used to better support the quality of patient care.
authors.affiliation: aDepartment of Cognitive Ergonomics, Faculty of Psychology bDepartment of Emergency Medicine, University Hospital of Liège, University of Liège, Liège, Belgium.
authors.forename: Aline
authors.initials: A
authors.lastname: Gillet
authors.forename: Alexandre
authors.initials: A
authors.lastname: Ghuysen
authors.forename: Suzanne
authors.initials: S
authors.lastname: Bonhomme
authors.forename: Vincent
authors.initials: V
authors.lastname: D'Orio
authors.forename: Anne Sophie
authors.initials: AS
authors.lastname: Nyssen
mesh_terms: D002985:Clinical Protocols; D003142:Communication; D003697:Delphi Technique; D004636:Emergency Service, Hospital / Q000592:standards; D006801:Humans; D062209:Patient Handoff / Q000592:standards; D058996:Quality Improvement; D017010:Reminder Systems