The Process of Handover in the Busy Emergency Centre: A Pre-Hospital Perspective from Johannesburg, South Africa

Abstract

Background Emergency centre handover usually takes place between the pre-hospital emergency care personnel who deliver the handover and the emergency centre personnel who receive the handover. Handover that is not effective may present risks to patient safety. One factor that may affect handover delivery is the process of handover within a busy emergency centre. Methods The data reported on in this study formed the qualitative component of a sequential explanatory mixed methods study. It used face-to-face, semi-structured interviews to gather data. Fifteen interviews were conducted with pre-hospital emergency care personnel from a range of qualification and scopes in South Africa. Interviews were transcribed verbatim and imported into Atlas.ti® for coding and analysis using a qualitative descriptive methodology. Results Pre-hospital emergency care participants identified a lack of emergency centre staff available to receive handover as a barrier to effective handover and attributed this to emergency centres being overworked and understaffed. This potentiated interruptions to handover and having to deliver multiple handovers for the same patient. Pre-hospital emergency care participants indicated a preference for handing over directly to a doctor. Conclusion Several potential process barriers to effective emergency centre handover were identified, including lack of personnel to receive handover, interruptions and the need to perform multiple handovers for the same patient. Generally, these barriers were attributed to the busy understaffed and overworked nature of emergency centres. We would encourage future research in emergency centre handover, specifically from the perspective of the personnel who receive handovers.