Optimizing the patient handoff between emergency medical services and the emergency department.
Annals of Emergency Medicine · 2014-08-07 · Qualitative study
Abstract
STUDY OBJECTIVE: Patient handoffs are known as high-risk events for medical error but little is known about the professional, structural, and interpersonal factors that can affect the patient transition from emergency medical services (EMS) care to the emergency department (ED). We study EMS providers' perspectives to generate hypotheses to inform and improve this handoff. METHODS: We conducted focus groups with EMS providers recruited at 3 national and regional conferences from January to March 2011 until theme saturation was reached; 7 focus groups were conducted with 48 EMS providers. Deidentified transcripts and notes were entered into QSR NVivo, coded, and analyzed to identify themes. RESULTS: EMS providers identified themselves as advocates for their patients during the challenging EMS-to-ED handoffs. Providers identified normative challenges they encounter in their communications with hospital staff, and features of EMS and hospital protocols that either facilitate or undermine effective handoffs from the out-of-hospital environment to the ED. They identified 4 key potential ways to improve the structure and process of the handoff: (1) communicate directly with the ED provider responsible for the patient's care; (2) increase interdisciplinary feedback, transparency, and shared understanding of scope of practice between out-of-hospital and hospital-based providers; (3) standardize some (but not all) aspects of the handoff; and (4) harness technology to close gaps in information exchange. CONCLUSION: These exploratory findings suggest that the effect of increasing EMS interactions with emergency physicians, standardizing handoff processes, and fostering interprofessional learning represent opportunities for future study and may serve as potential solutions for the high-risk EMS-ED patient transition.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Clinician perspective · Communication & handover · Teamwork & human factors
Related articles
- Prehospital nursing students' experiences of patient safety culture in emergency medical services-A qualitative study. (J Clin Nurs, 2023)
- Communication of preclinical emergency teams in critical situations: A nationwide study. (PLoS One, 2021)
- [Miscommunication as a risk focus in patient safety : Work process analysis in prehospital emergency care]. (Anaesthesist, 2018)
- Lost in translation: maximizing handover effectiveness between paramedics and receiving staff in the emergency department. (Emerg Med Australas, 2009)
- Structured communication during emergency response driving: Safety-critical points identified by Finnish emergency response driving experts. (Australas Emerg Care, 2022)
- Verbal and visual information exchange in EMS-to-ED patient handovers: An observational and attitudinal study. (Int Emerg Nurs, 2026)