As any healthcare professional working within the NHS, we are exposed to increasing stress and workload. The intrinsic limitations of our memory, our environment and the impact of stress and fatigue can all influence our communication with others. Working frequently in shifts results in dynamic teams, with members not being constant and, therefore, an inherent lack of team stability. Handover of care is therefore essential in developing a shared mental model and effective continuity of care.
Before each shift handover or before a complex task, such as starting a surgical list, it is imperative to brief as a team. The team brief should consist of:
- who is on the team today and roles of each member
- what is our plan of care (establishing a shared mental model)
- staff availability – for example on delivery suite this could be midwifery and obstetric staffing, operational pressure escalation level (OPEL) status of the delivery suite and neonatal unit and available managers for support
- how the workload can be shared between the team.
Once the brief has been established, handover can then occur. Handover between shifts should be multidisciplinary, formal and follow a consistent format. Importantly handover should:
- have adequate time without distractions or interruptions
- be clearly led – either by the team leader, coordinator or most senior person on the outgoing team, but most importantly by the person who has maintained situational awareness throughout the previous shift, and therefore has the knowledge to provide an accurate handover
- exchange of sufficient and relevant information using standardised communication tools such as SBAR for information. This involves specifically highlighting patients with concerns, or who are at high risk and stating clear plans
- description and assignment of uncompleted tasks.