Integrating ECCHo outcomes

In the final chapter, we bring together the findings, themes, issues and perspectives that emerged from the ECCHo research around Australia. Although the four ECCHo teams worked in very different hospital contexts, focusing on different handover types with different clinician and patient groups, as we pooled and discussed findings we were struck by the commonalities. At all the research sites clinicians faced enormous challenges to communicate complex information efficiently, concisely and clearly in the noisy, busy and semi-public spaces of hospital wards. At all sites clinicians moved between spoken interactions and written documents, each problematic in its own way. At all sites, there was a common need for strategies, tools and policy directions grounded in empirical communication data that recognized the patient’s right to be involved while acknowledging the clinicians’ responsibility and accountability for patient safety. The iCARE3 model in chapter 15 is both a theoretical model and a practical tool to improve clinical handover communication. The model grew directly from our analyses of the spoken interaction, survey, interview, observational, and written audit data gathered at all four sites.