Pascoe Heather, Gill Stephen D, Hughes Andrew, McCall-White Martin
Geelong Hospital, Barwon Health.
Australas Med J. 2014 Sep 30;7(9):363-71. doi: 10.4066/AMJ.2014.2060. eCollection 2014.
The Australian National Safety and Quality Health Service (NHQHS) Standards (the "Standards") provide external criteria for hospitals to assess their practices. Since the introduction of the Standards, no Australian hospital has published a report on how its handover practices compare to these Standards.
To evaluate house medical officer (HMO) shift-to-shift handover practices against the Standards at a large regional hospital.
All HMOs employed by Barwon Health were invited to participate in our qualitative and quantitative study by completing an online questionnaire and taking part in a focus group.
Of the 100 HMOs, 61 completed the questionnaire and 11 HMOs participated in focus groups. Questionnaire results revealed that HMOs were concerned about the quality of shift-to-shift handovers. Fifty-three per cent reported that current shift-to-shift handover practices could be putting patients at risk of adverse events. Ninety-eight per cent indicated that the handover processes could be improved. One hundred per cent of the HMOs stated that the quality of handover varies according to the doctors involved. In the focus groups, issues were raised about current handover structure, documentation, attendance, content, and training.
HMOs in the current study identified multiple deficiencies in handover practice with regard to structure, documentation, attendance, content, and training. The primary methods to improve handover include making it more structured and standardised, and to provide HMOs with handover training.
澳大利亚国家安全与质量健康服务（NHQHS）标准（“标准”）为医院评估其医疗实践提供了外部标准。自该标准引入以来，尚无澳大利亚医院发布关于其交接班实践与这些标准对比情况的报告。
在一家大型地区医院，对照标准评估住院医师（HMO）的交接班实践。
邀请巴旺健康中心雇佣的所有住院医师通过填写在线问卷并参加焦点小组来参与我们的定性和定量研究。
100名住院医师中，61人完成了问卷，11人参加了焦点小组。问卷结果显示，住院医师担心交接班的质量。53%的人报告称，当前的交接班实践可能会使患者面临不良事件风险。98%的人表示交接班流程可以改进。100%的住院医师称，交接班质量因涉及的医生而异。在焦点小组中，人们提出了关于当前交接班结构、文件记录、出勤情况、内容和培训等方面的问题。
本研究中的住院医师指出了交接班实践在结构、文件记录、出勤情况、内容和培训方面存在的多个不足之处。改进交接班的主要方法包括使其更具结构化和标准化，并为住院医师提供交接班培训。
