Structured multidisciplinary intershift handover (SMITH): a tool for promoting safer intrapartum care

On the labour ward, the key to achieving patient safety is the intershift handover, which affords an opportunity for the team to undertake a baseline assessment of the current situation, anticipate problems, plan contingencies and subsequently maintain situational awareness. If optimised, the handover has immense potential not only for enhancing patient safety but also for reducing stress to staff. The handover should be regarded not as an end but as the beginning of the process of maintaining individual and team situational awareness throughout the shift. Each maternity unit should have a Structured Multidisciplinary Intershift Handover (SMITH) protocol, which encompasses pre-handover, handover and post-handover guidance. This paper describes the underlying principles, benefits and content of a SMITH protocol.