Clinical Hand Over: A neglected domain in our Health Care
Authors:   Al-Nafees Medical College, Islamabad, Ahmed Ishtiaq 
Published: September 2022

Clinical handover or shift handover refers to “the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person or professional group on a temporary or permanent basis1. It is considered a vital and valuable affair in healthcare pathway in a clinical practice. In fact, it is a complex domain in advanced communication skills in medical sciences, which is being recognized increasingly to enhance patient care and safety. It involves the effective communication of high‑quality clinical information while transferring the patients care responsibility to other person or clinical team or at change of shift or any time or transferring to another hospital2. In clinical practice, if relevant clinical information’s were not shared timely and accurately, may results delay in diagnosis, delayed or inappropriate treatment, any adverse events or omission of care. To overcome this, an effective and accurate clinical handover is very crucial in promoting health care continuity and patient safety3. The World Health Organization, Association of American Medical Colleges and Joint Commission4 has also recognized the importance and emphasize the need to improve handovers quality. These organizations have declared it a core entrustable professional activity and issued a mandate by emphasizing the health care institutes to standardize the handovers process and incorporate handover training of their employees in order to improve the consistency and minimize the vulnerability to errors5,6. It is estimated that in USA over 300 million, in Australia more than 40 million and in UK above 100 million clinical handovers are conducted each year7. Arguably, this number is making this practice most frequent and significant process in communication between clinicians and paramedical staff in providing safe patient care. Due to increasing emphasis on person-centered medical care all over the world, a change from traditional to structured handover’s practices is being developed. Literature is now favoring the use of a structured handover framework and advocates patient’s placement at the centre of their care. It is purely a communicative event which can only be achieved through linguistic exchange, by clinicians or paramedics discussion and writing which is conducted between outgoing and oncoming staff at the time of shift change or during patient hand over. This acts a key tool in ensuring the continuity of patient’s information’s which in turns are very important for the continuity of care8. For better outcome technological support like templates, internet, computers, soft wares etc are also used to enhance the effectiveness and safety of this process5,7. To meet the colleague, organizational and patients’ requirements, the staff and doctors should be made aware about its importance and trained to deliver an effective handover9,10. It is also imperative that doctors and paramedical staff should identify any potential barriers encountered during handovers to effectively address these obstacles. As a part of Good Medical Practice, it is recommended and expected that all health professionals should learn and practice excellent handover skills, in order to ensure effective communication between each other of important patients’ clinical information, to ensure patient safety and enable inter-professional collaboration10. It has been reported in literature that the poorly conducted shift handovers, most likely threaten patient’s quality of care, safety and continuity of care2.