Clinical Safety Research Unit, Department of Surgery and Cancer, Imperial College London, London, UK.
Int J Surg. 2012;10(7):355-9. doi: 10.1016/j.ijsu.2012.05.010. Epub 2012 May 26.
Clinical handover (handoff, sign out) is frequently implicated as a cause of adverse events in hospitalised patients. Complex social interactions such as handover are subject to the teamwork skills of the participants and there is increasing evidence that the quality of teamwork in handover affects outcome. Teamwork skills have been assessed in one-to-one handovers but the applicability of these measurement tools to healthcare team shift handovers remains unproven. This study aimed to assess the feasibility of measurement of teamwork skills in shift handover and the applicability of adapted teamwork skills rating scales to a shift handover environment.
Morning surgical shift handovers were assessed for completeness of information transfer, duration, interruptions and handover attendance. Handover teamwork skills were evaluated using two validated rating scales, adapted from one-to-one handovers and intra-operative teamwork skill measurement.
50 handovers, including 306 patients were observed. Communication checklist completion was 97% but the quality of teamwork skills varied widely between handovers. There was very good concurrent validity between the two teamwork skill rating scales (Spearman's rho = 0.67, p < 0.001). There was no significant correlation between content completion, duration, interruptions or attendance and teamwork skill ratings.
Teamwork skills vary widely between handovers and can be consistently scored using both rating scales. It is feasible to use adapted teamwork skill rating scales in shift handover and they appear to measure different constructs to traditional handover measures such as interruptions and communication checklist completion. The assessment of teamwork skills is a necessary complement to the assessment of completeness of information transfer when evaluating the overall quality of handover.
临床交接（交班、签出）经常被认为是住院患者不良事件的原因之一。像交接这样复杂的社会互动受到参与者团队合作技能的影响，越来越多的证据表明交接中的团队合作质量会影响结果。团队合作技能已经在一对一交接中进行了评估，但这些测量工具在医疗团队轮班交接中的适用性尚未得到证实。本研究旨在评估在轮班交接中测量团队合作技能的可行性，以及适应性团队合作技能评分量表在轮班交接环境中的适用性。
评估晨间外科轮班交接的信息传递完整性、时长、中断情况和交接出席情况。使用两个经过验证的评分量表评估交接的团队合作技能，这些量表改编自一对一交接和术中团队合作技能测量。
观察了 50 次交接，包括 306 名患者。沟通检查表的完成率为 97%，但团队合作技能的质量在交接之间差异很大。两种团队合作技能评分量表之间具有很好的同时效度（Spearman 相关系数为 0.67，p<0.001）。内容完成情况、时长、中断或出席情况与团队合作技能评分之间没有显著相关性。
团队合作技能在交接之间差异很大，可以使用这两种评分量表进行一致评分。在轮班交接中使用适应性团队合作技能评分量表是可行的，它们似乎与传统的交接评估指标（如中断和沟通检查表完成情况）测量不同的结构。在评估整体交接质量时，评估团队合作技能是对信息传递完整性评估的必要补充。
