Development of a Training Toolbox to Prevent Handover Error in Health Care

• In Event: Roundtable Session 33
  In Roundtable Session: Errors and Their Potential for Learning in the Professions

Abstract

One of the reasons for unsafe situations in health care is failing communication both within and across teams and settings. The Handover project (www.handover.eu) aims at identifying both the current situation in patient handovers between primary and secondary health care providers across Europe, to develop solutions for the problems identified and to develop training packages that can help improve care professionals’ skills and practices.
The workpackage we’ll report on in this contribution has the following goals:
• to identify and validate factors determining the success of integrating the optimal patient care micro-system continuum of communication and transparancy, and
• to develop training tools to assist a successful implementation of the communication model.

The strategy we used can be best described as a design approach informed by mixed-method research and with intermediate evaluation steps. As a first step a literature review was done and data were collected in several European countries about present handover practices and professionals’ learning needs as perceived by local training specialists. Based on these data it was concluded that the variation across Europe – both in terms of handover practices and problems, and the perceived learning needs of different kinds of health care personnel and different levels of expertise – was so huge that a single training package with or without implementation support was not practical or possible. Instead, it was decided to develop a training toolbox. The required contents and user specifications were derived from the data that were collected and described as ‘personas’. The same was done with the requirements for communication with the toolbox and with other members of the training specialist community. Momentarily a first implementation is in progress. It will be tested later this year with a panel of training specialists who did not participate in the first round of data collection and who are located in countries that were not included.

The project departed from the acknowledgement that mistakes are being made, and that a considerable quantity of these errors regards handovers. The different workpackages focus on the identification of the barriers and facilitators to effective handover in the social, linguistic and technological contexts, on the identification of effective communication, and on cultures of safety in order to test and develop practices and procedures that optimize communication and transparency around handover. Also in these workpackages, it was recognized that different situations require different solutions although the basic premises may remain the same. As a result, the content part of the toolbox will contain a mixture of part-solutions and training elements plus ways and methods to combine them into a training design and programme, adapted to the needs of the local situation and characteristics of the personnel. To that aim a tagging system will be worked out that, using the following dimensions, can be used to select relevant training approaches and methods: Expertise and hierarchical position/responsibility, Innovativeness, and Stages of change.

Authors

• Henny Boshuizen, Open Universiteit Nederland

• Wendy Kicken, The Open University of the Netherlands

• Slavi Stoyanov, The Open University of the Netherlands

• Marcel Van der Klink, The Open University of the Netherlands