The Experts below are selected from a list of 1629 Experts worldwide ranked by ideXlab platform
Paul Turner - One of the best experts on this subject based on the ideXlab platform.
-
understanding how Clinical judgement and communicative practices interact with the use of an electronic Clinical Handover system
Studies in health technology and informatics, 2013Co-Authors: K C Yee, M C Wong, Paul TurnerAbstract:Clinical Handover is a high risk scenario involving the transfer of information, responsibility and accountability for patient care. Many strategies have been proposed to improve Clinical Handover and reduce risks it can pose to the safety and quality of patient care. The development and implementation of electronic tools provides one mechanism for structuring and streamlining information transfer to support more standardised Handover practices. However, Clinical judgement remains a valued, fundamental aspect of Clinical practice and its communication during Handover is open to variation in ways that may compromise patient safety. This research examines these issues based on evidence generated from a user-centred approach involving clinicians in the development and implementation of an electronic Clinical Handover system. The paper highlights how Clinical judgements and communicative practices interact with an electronic Clinical Handover system, and discusses their potential implications for patient safety as part of a broader Clinical Handover improvement project.
-
HIC - Understanding how Clinical judgement and communicative practices interact with the use of an electronic Clinical Handover system.
Studies in health technology and informatics, 2013Co-Authors: Kwang Chien Yee, Ming Chao Wong, Paul TurnerAbstract:Clinical Handover is a high risk scenario involving the transfer of information, responsibility and accountability for patient care. Many strategies have been proposed to improve Clinical Handover and reduce risks it can pose to the safety and quality of patient care. The development and implementation of electronic tools provides one mechanism for structuring and streamlining information transfer to support more standardised Handover practices. However, Clinical judgement remains a valued, fundamental aspect of Clinical practice and its communication during Handover is open to variation in ways that may compromise patient safety. This research examines these issues based on evidence generated from a user-centred approach involving clinicians in the development and implementation of an electronic Clinical Handover system. The paper highlights how Clinical judgements and communicative practices interact with an electronic Clinical Handover system, and discusses their potential implications for patient safety as part of a broader Clinical Handover improvement project.
-
Clinical Handover improvement in context exploring tensions between user centred approaches and standardisation
Studies in health technology and informatics, 2013Co-Authors: M C Wong, Paul Turner, K C YeeAbstract:User-centred approaches in the development and evaluation of health information systems promote the importance of involving users and understanding their social contexts to optimise the quality and safety of these systems for patient care. Simultaneously, the standardisation of Clinical practices has also been advocated to improve the quality and safety of patient care. In the context of Clinical Handover improvement within three different departments in one tertiary teaching hospital, this paper highlights the potential for tensions between these two approaches and explores their implications. Based on a user-centred approach, the paper reports on the unique requirements identified within each of the three departments for an information system to support improved Clinical Handover. Each department had Clinical practices, work cultures and user requirements that needed to be considered and accommodated. This led to the project developing distinct minimum data sets for each of the three departments that posed challenges for efforts to standardise Handover practices across the hospital and for building an integrated information system. While on the one hand accommodating unique departmental user requirements was valuable, they revealed the potential for the introduction of quality and safety risks at the organisational level. To resolve these tensions, the project team developed an approach called flexible standardisation that has now been embedded in Australia' s national guidelines on Clinical Handover improvement.
-
CSHI - Clinical Handover improvement in context: exploring tensions between user-centred approaches and standardisation.
Studies in health technology and informatics, 2013Co-Authors: Ming Chao Wong, Paul Turner, Kwang Chien YeeAbstract:User-centred approaches in the development and evaluation of health information systems promote the importance of involving users and understanding their social contexts to optimise the quality and safety of these systems for patient care. Simultaneously, the standardisation of Clinical practices has also been advocated to improve the quality and safety of patient care. In the context of Clinical Handover improvement within three different departments in one tertiary teaching hospital, this paper highlights the potential for tensions between these two approaches and explores their implications. Based on a user-centred approach, the paper reports on the unique requirements identified within each of the three departments for an information system to support improved Clinical Handover. Each department had Clinical practices, work cultures and user requirements that needed to be considered and accommodated. This led to the project developing distinct minimum data sets for each of the three departments that posed challenges for efforts to standardise Handover practices across the hospital and for building an integrated information system. While on the one hand accommodating unique departmental user requirements was valuable, they revealed the potential for the introduction of quality and safety risks at the organisational level. To resolve these tensions, the project team developed an approach called flexible standardisation that has now been embedded in Australia' s national guidelines on Clinical Handover improvement.
-
user centered design in Clinical Handover exploring post implementation outcomes for clinicians
Studies in health technology and informatics, 2013Co-Authors: M C Wong, Elizabeth Cummings, Paul TurnerAbstract:This paper examines the outcomes for clinicians from their involvement in the development of an electronic Clinical hand-over tool developed using principles of user-centered design. Conventional e-health post-implementation evaluations tend to emphasize technology-related (mostly positive) outcomes. More recently, unintended (mostly negative) consequences arising from the implementation of e-health technologies have also been reported. There remains limited focus on the post-implementation outcomes for users, particularly those directly involved in e-health design processes. This paper presents detailed analysis and insights into the outcomes experienced post-implementation by a cohort of junior clinicians involved in developing an electronic Clinical Handover tool in Tasmania, Australia. The qualitative methods used included observations, semi-structured interviews and analysis of Clinical Handover notes. Significantly, a number of unanticipated flow-on effects were identified that mitigated some of the challenges arising during the design and implementation of the tool. The paper concludes by highlighting the importance of identifying post-implementation user outcomes beyond conventional system adoption and use and also points to the need for more comprehensive evaluative frameworks to encapsulate these broader socio-technical user outcomes.
Patricia Mcgarrity - One of the best experts on this subject based on the ideXlab platform.
-
Evaluation of the acceptability of standardised Clinical Handover tools at four Victorian health services.
The Medical journal of Australia, 2009Co-Authors: Diana M Quin, Annie L Moulden, Simon H Fraser, Olive K E Lee, Patricia McgarrityAbstract:To evaluate the appropriateness and acceptability of five standardised tools for shift-to-shift Clinical Handover (CH). In July 2007, a pilot project was conducted in four Victorian public health services. Five standardised tools developed by the Victorian Quality Council were trialled at night medical Handover: an organisational readiness checklist, a suggested organisational policy, a recommended organisational protocol, a CH template containing a minimum dataset to be collected, and a set of key performance indicators. Baseline and post-trial data and observational data were collected, and participating medical staff completed questionnaires before and after project implementation to gauge their opinions on the usefulness of the tools. The tools considered most useful were the organisational readiness checklist, the suggested organisational policy, the protocol for CH, and the CH template. Using the number of medical emergency team calls and incident reports as key performance indicators was not considered appropriate. The project highlighted that organisational support and commitment and stakeholder engagement and involvement are essential for implementing and sustaining changes in CH.
-
Evaluation of the acceptability of standardised Clinical Handover tools at four Victorian health services.
The Medical Journal of Australia, 2009Co-Authors: Diana M Quin, Annie L Moulden, Simon H Fraser, Olive K E Lee, Patricia McgarrityAbstract:Objective: To evaluate the appropriateness and acceptability of five standardised tools for shift-to-shift Clinical Handover (CH). Setting and participants: In July 2007, a pilot project was conducted in four Victorian public health services. Five standardised tools developed by the Victorian Quality Council were trialled at night medical Handover: an organisational readiness checklist, a suggested organisational policy, a recommended organisational protocol, a CH template containing a minimum dataset to be collected, and a set of key performance indicators. Baseline and post-trial data and observational data were collected, and participating medical staff completed questionnaires before and after project implementation to gauge their opinions on the usefulness of the tools. Results: The tools considered most useful were the organisational readiness checklist, the suggested organisational policy, the protocol for CH, and the CH template. Using the number of medical emergency team calls and incident reports as key performance indicators was not considered appropriate. Conclusions: The project highlighted that organisational support and commitment and stakeholder engagement and involvement are essential for implementing and sustaining changes in CH.
Kwang Chien Yee - One of the best experts on this subject based on the ideXlab platform.
-
Clinical Handover improvement for safer patient care : exploring the practical aspects of organisational processes and the theoretical aspects of the safety value alignment model
2016Co-Authors: Kwang Chien YeeAbstract:This PhD thesis is a synthesis of research work, and analysis and reflections from 7 out of a series of 18 publications from 2005-2013, with the aim of answering the following research questions: 1. What are the understanding and practices of Clinical Handover from the perspective of clinicians? 2. What interventions are required to improve Clinical Handover from the perspective of clinicians? 3. What are the essential elements of Clinical Handover improvement? Clinical Handover, defined as "the transfer of responsibility and accountability of patient care from one team of healthcare professionals to the other", is an essential part of Clinical practice for delivering safe and high quality patient care. Poor Clinical Handover has been associated with medical errors, adverse Clinical events, medico-legal claims and patient complaints. With the increasing emphasis on reduction in working hours of healthcare professionals to reduce fatigue, Clinical Handover has become increasingly important in order to deliver safe patient care. While the literature has provided guidance on how to improve Clinical Handover, there remains a lack of clear understanding of Clinical Handover practices and a lack of a conceptual understanding of different strategies and interventions to improve Clinical Handover, especially from the perspective of clinicians across different Clinical practice areas, institutions and professional boundaries. This thesis is written based on the PhD candidate's published work in Clinical Handover improvement. It is the product of analysis and reflections of a selection of 7 publications based on research projects in the field of Clinical Handover improvement from 2005-2013, after the PhD candidate's involvement in local, regional and national Clinical Handover improvement programs. This thesis provides a synthesis and review of these 7 key publications. Through this process, five key findings are described and discussed. This thesis then provides an analysis and reflection of these publications to develop a conceptual model to understand strategies and interventions aimed at improving Clinical Handover. This thesis firstly explores and reflects on the current literature in the field of Clinical Handover improvement. An analysis of current literature categorises the literature into three fields: safety and Clinical Handover, standardisation of Clinical Handover practices and engagement of clinicians to improve Clinical Handover. This thesis then provides detailed Clinical and research context for primary data collection and data analysis utilised in the research project. This research project was conducted in two parts. The first part of the research project started in October 2005 and was conducted at the Department of General Internal Medicine, Royal Hobart Hospital. The first part of the research project aimed to understand Clinical Handover and Clinical Handover improvement among medical practitioners with the ultimate aim of developing an electronic tool to support Clinical Handover. Data collection involved observations, interviews and Clinical Handover notes analysis. Data analysis involved open, axial and selective coding applying grounded theory principles. This part of the research formed the foundation for the second part of the research project to take place. The second part of the research project was conducted between 2007 and 2009. It was also conducted at the Royal Hobart Hospital, Tasmania, Australia but across 6 Clinical settings: Medical and nursing Handover at the Department of General Internal Medicine, Department of Emergency Medicine and Department of General Surgery. Data collection techniques used were the same as the first part of the research project. It involved observations, interviews and Clinical Handover notes analysis. All collected data were analysed using open, axial and selective coding techniques, applying grounded theory principles. Both the first and the second part of the research project produced publications which are included in this thesis.
-
HIC - Understanding how Clinical judgement and communicative practices interact with the use of an electronic Clinical Handover system.
Studies in health technology and informatics, 2013Co-Authors: Kwang Chien Yee, Ming Chao Wong, Paul TurnerAbstract:Clinical Handover is a high risk scenario involving the transfer of information, responsibility and accountability for patient care. Many strategies have been proposed to improve Clinical Handover and reduce risks it can pose to the safety and quality of patient care. The development and implementation of electronic tools provides one mechanism for structuring and streamlining information transfer to support more standardised Handover practices. However, Clinical judgement remains a valued, fundamental aspect of Clinical practice and its communication during Handover is open to variation in ways that may compromise patient safety. This research examines these issues based on evidence generated from a user-centred approach involving clinicians in the development and implementation of an electronic Clinical Handover system. The paper highlights how Clinical judgements and communicative practices interact with an electronic Clinical Handover system, and discusses their potential implications for patient safety as part of a broader Clinical Handover improvement project.
-
CSHI - Clinical Handover improvement in context: exploring tensions between user-centred approaches and standardisation.
Studies in health technology and informatics, 2013Co-Authors: Ming Chao Wong, Paul Turner, Kwang Chien YeeAbstract:User-centred approaches in the development and evaluation of health information systems promote the importance of involving users and understanding their social contexts to optimise the quality and safety of these systems for patient care. Simultaneously, the standardisation of Clinical practices has also been advocated to improve the quality and safety of patient care. In the context of Clinical Handover improvement within three different departments in one tertiary teaching hospital, this paper highlights the potential for tensions between these two approaches and explores their implications. Based on a user-centred approach, the paper reports on the unique requirements identified within each of the three departments for an information system to support improved Clinical Handover. Each department had Clinical practices, work cultures and user requirements that needed to be considered and accommodated. This led to the project developing distinct minimum data sets for each of the three departments that posed challenges for efforts to standardise Handover practices across the hospital and for building an integrated information system. While on the one hand accommodating unique departmental user requirements was valuable, they revealed the potential for the introduction of quality and safety risks at the organisational level. To resolve these tensions, the project team developed an approach called flexible standardisation that has now been embedded in Australia' s national guidelines on Clinical Handover improvement.
-
"HAND ME AN ISOBAR": a pilot study of an evidence-based approach to improving shift-to-shift Clinical Handover
The Medical Journal of Australia, 2009Co-Authors: Kwang Chien Yee, Ming C Wong, Paul TurnerAbstract:Objective: To develop, using an evidence-based approach, a standardised operating protocol (SOP) and minimum dataset (MDS) to improve shift-to-shift Clinical Handover by medical and nursing staff in a hospital setting. Design, setting and participants: A pilot study conducted in six Clinical areas (nursing and medical Handovers in general medicine, general surgery and emergency medicine) at the Royal Hobart Hospital between 1 October 2005 and 30 September 2008. Data collection and analysis involved triangulation of qualitative techniques; 120 observation sessions and 112 interviews involving nurses and junior medical officers were conducted across the six Clinical areas; information on more than 1000 individual patient Handovers was analysed. Results: Wedevelopedanoverarchingfour-stepSOPandMDSforClinicalHandover, summarised by the acronym "HAND ME AN ISOBAR". This standardised solution supports flexible adaptation to local circumstances. Conclusion: A standardised protocol for Clinical Handover can be developed and validated across professional and disciplinary boundaries. It is anticipated that our model will be transferable to other sites and Clinical settings.
-
MIE - Involving clinicians in the development of an electronic Clinical Handover system - thinking systems not just technology.
Studies in health technology and informatics, 2008Co-Authors: Ming Chao Wong, Paul Turner, Kwang Chien YeeAbstract:While the need to 'involve the user' in information technology (IT) development is almost a mantra amongst information systems specialists, numerous IT projects continue to fail because of an inability to capture user insights or respond to users needs. Although there are clearly practical difficulties in addressing and responding to the heterogeneous requirements expressed by different users, marginalizing these views ultimately is to the detriment of the systems built. This paper describes the development of an electronic Clinical Handover system at the Department of General Internal Medicine (DGIM), Royal Hobart Hospital (RHH). More specifically, the paper aims to highlight how to engage meaningfully with clinicians in the development of a sustainable system. It is anticipated that by drawing attention to the importance of users and by outlining the practical experience of dealing with the diversity of requirements and views expressed, the paper can contribute to a stronger recognition within the domain of eHealth for a user-centred systems approach to IT development.
Diana M Quin - One of the best experts on this subject based on the ideXlab platform.
-
Evaluation of the acceptability of standardised Clinical Handover tools at four Victorian health services.
The Medical journal of Australia, 2009Co-Authors: Diana M Quin, Annie L Moulden, Simon H Fraser, Olive K E Lee, Patricia McgarrityAbstract:To evaluate the appropriateness and acceptability of five standardised tools for shift-to-shift Clinical Handover (CH). In July 2007, a pilot project was conducted in four Victorian public health services. Five standardised tools developed by the Victorian Quality Council were trialled at night medical Handover: an organisational readiness checklist, a suggested organisational policy, a recommended organisational protocol, a CH template containing a minimum dataset to be collected, and a set of key performance indicators. Baseline and post-trial data and observational data were collected, and participating medical staff completed questionnaires before and after project implementation to gauge their opinions on the usefulness of the tools. The tools considered most useful were the organisational readiness checklist, the suggested organisational policy, the protocol for CH, and the CH template. Using the number of medical emergency team calls and incident reports as key performance indicators was not considered appropriate. The project highlighted that organisational support and commitment and stakeholder engagement and involvement are essential for implementing and sustaining changes in CH.
-
Evaluation of the acceptability of standardised Clinical Handover tools at four Victorian health services.
The Medical Journal of Australia, 2009Co-Authors: Diana M Quin, Annie L Moulden, Simon H Fraser, Olive K E Lee, Patricia McgarrityAbstract:Objective: To evaluate the appropriateness and acceptability of five standardised tools for shift-to-shift Clinical Handover (CH). Setting and participants: In July 2007, a pilot project was conducted in four Victorian public health services. Five standardised tools developed by the Victorian Quality Council were trialled at night medical Handover: an organisational readiness checklist, a suggested organisational policy, a recommended organisational protocol, a CH template containing a minimum dataset to be collected, and a set of key performance indicators. Baseline and post-trial data and observational data were collected, and participating medical staff completed questionnaires before and after project implementation to gauge their opinions on the usefulness of the tools. Results: The tools considered most useful were the organisational readiness checklist, the suggested organisational policy, the protocol for CH, and the CH template. Using the number of medical emergency team calls and incident reports as key performance indicators was not considered appropriate. Conclusions: The project highlighted that organisational support and commitment and stakeholder engagement and involvement are essential for implementing and sustaining changes in CH.
Ming Chao Wong - One of the best experts on this subject based on the ideXlab platform.
-
HIC - Understanding how Clinical judgement and communicative practices interact with the use of an electronic Clinical Handover system.
Studies in health technology and informatics, 2013Co-Authors: Kwang Chien Yee, Ming Chao Wong, Paul TurnerAbstract:Clinical Handover is a high risk scenario involving the transfer of information, responsibility and accountability for patient care. Many strategies have been proposed to improve Clinical Handover and reduce risks it can pose to the safety and quality of patient care. The development and implementation of electronic tools provides one mechanism for structuring and streamlining information transfer to support more standardised Handover practices. However, Clinical judgement remains a valued, fundamental aspect of Clinical practice and its communication during Handover is open to variation in ways that may compromise patient safety. This research examines these issues based on evidence generated from a user-centred approach involving clinicians in the development and implementation of an electronic Clinical Handover system. The paper highlights how Clinical judgements and communicative practices interact with an electronic Clinical Handover system, and discusses their potential implications for patient safety as part of a broader Clinical Handover improvement project.
-
CSHI - Clinical Handover improvement in context: exploring tensions between user-centred approaches and standardisation.
Studies in health technology and informatics, 2013Co-Authors: Ming Chao Wong, Paul Turner, Kwang Chien YeeAbstract:User-centred approaches in the development and evaluation of health information systems promote the importance of involving users and understanding their social contexts to optimise the quality and safety of these systems for patient care. Simultaneously, the standardisation of Clinical practices has also been advocated to improve the quality and safety of patient care. In the context of Clinical Handover improvement within three different departments in one tertiary teaching hospital, this paper highlights the potential for tensions between these two approaches and explores their implications. Based on a user-centred approach, the paper reports on the unique requirements identified within each of the three departments for an information system to support improved Clinical Handover. Each department had Clinical practices, work cultures and user requirements that needed to be considered and accommodated. This led to the project developing distinct minimum data sets for each of the three departments that posed challenges for efforts to standardise Handover practices across the hospital and for building an integrated information system. While on the one hand accommodating unique departmental user requirements was valuable, they revealed the potential for the introduction of quality and safety risks at the organisational level. To resolve these tensions, the project team developed an approach called flexible standardisation that has now been embedded in Australia' s national guidelines on Clinical Handover improvement.
-
MedInfo - User-centered design in Clinical Handover: exploring post-implementation outcomes for clinicians.
Studies in health technology and informatics, 2013Co-Authors: Ming Chao Wong, Elizabeth Cummings, Paul TurnerAbstract:This paper examines the outcomes for clinicians from their involvement in the development of an electronic Clinical hand-over tool developed using principles of user-centered design. Conventional e-health post-implementation evaluations tend to emphasize technology-related (mostly positive) outcomes. More recently, unintended (mostly negative) consequences arising from the implementation of e-health technologies have also been reported. There remains limited focus on the post-implementation outcomes for users, particularly those directly involved in e-health design processes. This paper presents detailed analysis and insights into the outcomes experienced post-implementation by a cohort of junior clinicians involved in developing an electronic Clinical Handover tool in Tasmania, Australia. The qualitative methods used included observations, semi-structured interviews and analysis of Clinical Handover notes. Significantly, a number of unanticipated flow-on effects were identified that mitigated some of the challenges arising during the design and implementation of the tool. The paper concludes by highlighting the importance of identifying post-implementation user outcomes beyond conventional system adoption and use and also points to the need for more comprehensive evaluative frameworks to encapsulate these broader socio-technical user outcomes.
-
An exploration of shift-to-shift Clinical Handover and Clinical Handover improvement using a user-centred approach at the Royal Hobart Hospital, Tasmania, Australia
2011Co-Authors: Ming Chao WongAbstract:This research explores shift-to-shift Clinical Handover and Clinical Handover improvement at the Royal Hobart Hospital's Department of General Internal Medicine using a user-centred approach and highlights the outcomes associated with using this approach. This research presents findings that contribute to an improved understanding of shift-to-shift Clinical Handover and to the role that an electronic tool can play in Clinical Handover improvement. Clinical Handover involves the transfer of information, professional responsibility and accountability for patient care from one Clinical team to another either temporarily or permanently, With changes in doctors' working hours and art increasing demand for flexible work practices, the need for mechanisms to support effective and efficient Handover processes for transferring information, responsibility and accountability has become recognised as increasingly important for the delivery of high quality safe health care. Clinical Handover has been identified as a high risk scenario for patient safety with dangers of discontinuity of care, medical errors, adverse events and the potential for legal claims of malpractice. With the emergence of debates on ehealth, a role for information systems has been promoted but there remains limited evidence on the impact of these systems on Clinical Handover. More broadly however, it is evident that the experiences of information systems in health care has not always been successful and that there might be consequences to patient safety after their implementation. In this context one set of approaches for improving the uptake and use of information systems recommends acquiring a detailed understanding of users needs through direct user engagement. These user-centred approaches have been proven successful in the development and implementation of ehealth systems, Based in the Department of General Internal Medicine the user-centred approach led to the conduct of a case study grounded in clinician (particularly interns and registrars) experiences, attitudes and insights towards Clinical Handover. The methodology used in this research adopted a subjective ontotogy and an interpretive epistemology. The research strategy involved a three phased approach. Phase One involved the use of thirty-eight observation sessions and seventeen semi-structured interviews with three clinician Broups - interns, registrars and consultants, to facilitate an in-depth understanding of Clinical Handover and Clinical Handover improvement within the Department of General Internal Medicine and also build rapport and trust with the participants. Phase Two involved the use of two focus groups with one group consisting of six interns and the other consisting of five registrars to validate the results obtained from Phase One before moving forward with design of the electronic tool. All participants were then invited to participate in four design workshops to work through the requirements of the electronic tool. Phase Three consisted of ten further observation sessions and fourteen semi-structured interviews three months after the introduction of the electronic tool to further explore the participant's understanding, expectations and experiences of Clinical Handover after involving them in the Clinical Handover improvement initiative, The data collected through all three phases were analysed using open axial and selective coding drawing on the principles of grounded theory. After analysing the data independently in each phase, the data were then analysed and Interpreted across the three phases to allow for the key findings to emerge. These key findings were then interpreted and discussed based on the researcher's understanding of the data and in relation to the available literature. The key findings that emerged are as follows: • Clinical Handover is a complex, dynamic and evolving Clinical system and its status needs to be viewed from a contextual, Clinical and user perspective. • A formal education and training program with established standards is imperative for Clinical Handover improvement. • Clinical Handover culture is important in Clinical Handover improvement and the development of a Clinical Handover culture requires an incremental approach. • The understanding of Clinical Handover amongst clinicians varies and this variability in understanding significantly influences the behaviours of clinicians during Clinical Handover and practice of Clinical Handover. • The strongest personal attributes that influence Clinical Handover and Clinical Handover improvement are cultural background and individual personalities. • Various factors affect Clinical Handover but it is the nature of these factors and their interrelationships that influence team dynamics which in turn influence Clinical Handover and Clinical Handover improvement. • There is a significant difference between perceived and actual Handover. This difference has a significant impact on Clinical Handover especially in the development of electronic tools. • Clinical Handover serves various different functions and these functions change after the introduction of electronic Clinical Handover support tool. • An over-arching user-centred approach is important to engage all users before conducting user-requirements for electronic Clinical Handover support tool design and implementation. • While a user-centred approach is extremely useful, there are many challenges associated with this approach in Clinical Handover improvement and quality and safety initiatives. • lf an electronic tool is to be introduced for Clinical Handover improvement, it is imperative to mandate the use of the electronic tool for all Clinical Handover sessions. This research has made a number of contributions at substantive, methodological and theoretical levels, At a substantive level, it has contributed to the understanding of Clinical Handover and Clinical Handover improvement and provided guidance on how an Information systems researcher can conduct research in a Clinical setting. This research has made a significant contribution to Clinical Handover improvement through the use of a user-centred approach as this approach has since been developed further and incorporated as the national guidelines for Clinical Handover improvement (OSSIE guide). This research has also informed further work conducted in the utilisation of electronic tools in Clinical Handover which has since been developed into the national guidelines for safe use of electronic tools in Clinical Handover (SafeTECH). At a methodological level, this research has illustrated the importance of using an over-arching user-centred approach within a multi-snapshot case study to understand Clinical Handover and Clinical Handover improvement, This research has suggested that the use of a user-centred approach within a multi-snapshot case study is very important in obtaining a clear understanding of Clinical practice which is not clearly defined from the users' perspective. This research has also contributed at a methodological level by demonstrating that the use of qualitative research techniques drawing on the principles of grounded theory to generate an understanding of a Clinical process which is not clearly defined is highly valuable. At a theoretical level, this research has developed a conceptual understanding of Clinical Handover from three perspectives: a contextual perspective, Clinical perspective and a user perspective. This conceptual understanding of Clinical Handover opens up new areas for future research.
-
A Guide for the Safe Use of Electronic Clinical Handover Tool
2009Co-Authors: Mjw Thomas, Paul Turner, C Pirone, K.a. Thompson, M Crotty, G Williamson, A Weissenfeld, L Mccusker, G Paech, Ming Chao WongAbstract:Handover is ‘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 basis’ (Australian Medical Association, 2006). Handover occurs at all transitions of patient care, from Handover between shifts on a ward, Handover between units within a facility, or Handover between different facilities during patient transfer (Arora, Johnson, Lovinger, Humphrey, & Meltzer, 2005; Patterson, Roth, Woods, Chow, & Gomes, 2004). Recently, Clinical Handover has been the focus of several national and international efforts to enhance quality and influence change. Of the many types of interventions that focus on improving Clinical Handover, the use of technology to support Handover has been an issue of increasing relevance with recent advances in health informatics. Much of the history of health informatics involves a specific focus on technical hardware and software issues involved in the development of Clinical information systems and other aspects of the medical informatics landscape. Only in the last few decades has the focus shifted to include human factors perspectives. This has increased our understanding of the ways in which complex technological interventions interact with and influence the people and organisations at the heart of health care delivery (Lorenzi, Riley, Blyth, Southon, & Dixon, 1997). This perspective is often called the ‘sociotechnical’ perspective as it seeks to understand the complex interface between the human and technological aspects of an intricate health system. This guide is written within this context, and provides guidance to clinicians, medical administrators, quality and safety staff, and health informatics professionals with respect to the safe use of electronic tools to support Clinical Handover. This guide is also designed to assist at all stages of the design and use of electronic Handover systems, from the investment in a new product right through to implementation and evaluation. In short, this guide covers the main considerations for ensuring the safe use of electronic tools to support Clinical Handover.