Changing staff: clinical handovers at shift changes

One of the main challenges in contemporary hospital healthcare is achieving safe, continuous, quality care for patients when the clinical staff caring for them change frequently. In most hospitals, nursing shifts change three times a day, seven days a week. At least two shifts of medical staff are needed to cover patient care during the day and overnight. The four chapters in this section draw on observed and audiorecorded data of medical shift-change handovers in emergency departments and nursing shift-change handovers in a general medical ward. The authors identify patient safety risks and analyze the contextual constraints and challenges clinical staff face when handing over in the busy, dynamic hospital environment. The practical communication strategies the authors suggest aim to ensure that both junior and senior clinicians can hand over in ways that keep the patient safe.