Hand me an isobar: a pilot study of an evidence-based approach to improving shift-to shift clinical handover

Objective: To develop, using an evidence-based approach, a standardised operating protocol (SOP) and minimum dataset (MDS) to improve shift-to-shift clinical handover by medical and nursing staff in a hospital setting. Design, setting and participants: A pilot study conducted in six clinical areas (nursing and medical handovers in general medicine, general surgery and emergency medicine) at the Royal Hobart Hospital between 1 October 2005 and 30 September 2008. Data collection and analysis involved triangulation of qualitative techniques; 120 observation sessions and 112 interviews involving nurses and junior medical officers were conducted across the six clinical areas; information on more than 1000 individual patient handovers was analysed. Results: Wedevelopedanoverarchingfour-stepSOPandMDSforclinicalhandover, summarised by the acronym “HAND ME AN ISOBAR”. This standardised solution supports flexible adaptation to local circumstances. Conclusion: A standardised protocol for clinical handover can be developed and validated across professional and disciplinary boundaries. It is anticipated that our model will be transferable to other sites and clinical settings.