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Watch the following video showing the handover of the patient at the receiving hospital and transfer to the critical care bed.

The main aim of the handover is to bring the receiving clinicians up to speed quickly with the critically-ill patient to ensure continuity of care. This is a crucial moment, where miscommunication, omission of information or distraction could compromise patient safety.

  • The use of a structured approach (for example, SBAR) makes information easier to digest and help to ensure key information is not omitted.
  • If you think of the handover as telling an interesting story it can help it to flow and be easier for the receiving team to understand and recall. You can practise the handover if you have time en route in the ambulance.
  • See how Alexia, the receiving doctor, uses notes to collect all the information and make sure she does not miss anything. She might have a structured sheet helping her to ask questions. There is space for the nurse-to-nurse handover which conveys important information, often with a different focus from a medical handover.

When To Hand Over?

  • There are different stages at which you might hand over the patient:
    • While the patient is still on the stretcher
    • As soon as the patient is moved into the bed
    • Once monitoring is switched over
  • There are advantages and drawbacks to each method – share in the comments when you choose to handover most commonly and what you think of this.
  • Certain situations may favour handing over once the patient is off the stretcher – when would you do this?
  • When it comes to transferring the patient onto the bed, Caroline is clearly leading and directs the team including the receiving critical care team. She checks each team member is happy with their role, which makes the move smooth and safe for the patient.
  • In some situations, there may be many people waiting to receive the patient who you may not have met before. It may be a noisy and unfamiliar environment
Clear communication and direction at this point is vital to prevent mishaps that may cause harm, such as dislodgement of tubes and lines or injury to the patient.
  • Towards the end you see how Alexia states that she is now in charge and has accepted the handover. In some countries, this (after handover) signifies the end of the transfer team’s legal responsibility. In other countries, the legal responsibility ends once the patient is in the hospital bed. How does it work in your country? When does the legal responsibility for the transfer team end? Share your experience in the comments.

Please note: this video is a simulation and does not depict a real-life clinical event. The clinical details used in the simulation are invented and do not describe real patients. Everyone featured has kindly given their permission for the video to be used.

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A Journey Through Transfer Medicine

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