The use of simulation-based training to assess and improve patient handover between prehospital and emergency personnel
Oral Presentation 6
Dr Shona Keogh, Dr Victoria Meighan
The use of simulation-based training to assess and improve patient handover between prehospital and emergency personnel
Intro:
Handover of patient information between prehospital healthcare providers and emergency physician in high stake emergency situations is imperative for high quality patient care and patient safety. It is essential that handover is used appropriately as it is effective tool in allowing a shared mental model of a patient’s condition. (Owen et al., 2009) Error cannot be eliminated from the handover process, however training in handover between teams reduces the incidence of error and risk. Read back is a critical safeguarding communication technique for reduction in risk. We sought to determine if simulation-based training in read back technique reduced the incidence of errors in patient information.
Methods
We performed twelve multi-disciplinary based medical emergency simulations between 2021 and 2022 focusing on handover of information between the National Ambulance prehospital providers and the emergency physician in the role as team lead. Standardised handover information was delivered using the IMIST Ambo acronym. The IMIST AMBO acronym stands for Identification, mechanism, injuries, signs, treatment and trends, allergies, medications, background and other information. Six of the scenarios were designed to have a failure to handover critical information which would subsequently be delivered if a read back was performed and the use of questioning to ascertain if any information was missed following a read back.
The simulation model was multidisciplinary and involved prehospital providers from the national ambulance service, medical and nursing staff from the emergency department, and intensive care doctors.
Results
There was a reduction in missed information when read back communication technique was performed as part of the clinical handover information between the prehospital and emergency team. Read back ensured hand over of
- Dangerous mechanism of injury
- Prehospital assessment and diagnosis
- Prehospital interventions
- Prehospital medications
- Relevant medical history, medications and drug allergies
Discussion
The handover process between prehospital teams and emergency department staff has been sparsely investigated previously. Handover is not just the delivery of information but also a dynamic task that involves critical thinking and clinical judgment. (Lee & Lim, 2021) Multidisciplinary simulation based medical education is a useful tool in both assessing and practicing communication techniques. It offers the opportunity for multi-professional learning, encourages teamwork and ensures critical information is communicated. We demonstrated a reduction in error in communication of vital information which is directly applicable to patient care.