title: Communication during handover in the pre-hospital/hospital interface in Italy: from evaluation to implementation of multidisciplinary training through high-fidelity simulation.
abstract: Communication failures in the pre-hospital/hospital interface have been identified as a major preventable cause of patient harm. This interface has not adequately been studied in Italy. In this study, we: (1) evaluated the communication of pre-hospital and hospital providers during handover through the analysis of simulation sessions; (2) identified the critical information that should be routinely communicated during handover with a survey administered to emergency triage nurses; (3) measured communication within this interface through the adaptation of an existing tool from a multidisciplinary focus group; (4) validated the adapted tool with the inter-rater agreement of physicians who reviewed video recordings from multidisciplinary simulations sessions; and (5) developed a handover training for pre-hospital providers and evaluated the communication improvement between pre- and post-training. In our simulations we found an absence of standardization of the handover communication process, marked variability in information communicated, and a lack of formal transfer of responsibility of patient care. We adapted existing handover communication tools for local use and developed a checklist for the evaluation of handover communication that had good inter-rater reliability. Lectures coupled with high-fidelity simulation exercises on handover did result in a statistically significant improvement in handover communication.
authors.affiliation: Inter-institutional Integrated Department, University of Florence and Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy, francescodojmi@yahoo.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Dojmi Di Delupis
authors.forename: Paolo
authors.initials: P
authors.lastname: Pisanelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Luccio
authors.forename: Maura
authors.initials: M
authors.lastname: Kennedy
authors.forename: Sabrina
authors.initials: S
authors.lastname: Tellini
authors.forename: Nadia
authors.initials: N
authors.lastname: Nenci
authors.forename: Elisa
authors.initials: E
authors.lastname: Guerrini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pini
authors.forename: Gian
authors.initials: G
authors.lastname: Franco Gensini
mesh_terms: D005069:Evaluation Studies as Topic; D006282:Health Personnel / Q000193:education; D006760:Hospitalization; D006801:Humans; D033183:Interdisciplinary Communication; D007558:Italy; D062209:Patient Handoff; D000066908:Simulation Training