Context, culture and (non-verbal) communication affect handover quality

Area of Science:

• Healthcare communication
• Patient safety research
• Medical sociology

Background:

• Transfers of care (handovers) present significant patient safety risks.
• Despite decades of research, handover science remains incomplete with few rigorously evaluated interventions.
• Face-to-face handovers are considered most reliable, but the definition of 'face-to-face' in practice is unclear.

Purpose of the Study:

• To investigate the role of non-verbal behaviors (NVB) in face-to-face patient handovers.
• To analyze how NVB influences the quality and accuracy of information delivery during care transitions.

Main Methods:

• Videotaped 52 nursing, medicine, and surgery handovers involving 238 patients.
• Employed qualitative data analysis using immersion/crystallisation methods over 18 months.
• Utilized a consensus-building approach among six researchers to identify themes in verbal, non-verbal, and physical interactions.

Main Results:

• Identified four patterns of non-verbal behavior: joint focus of attention, 'the poker hand,' parallel play, and kerbside consultation.
• Joint focus of attention demonstrated the highest potential for quality and reliability in handovers.
• This optimal pattern occurred infrequently, indicating a need for targeted education and improvement.

Conclusions:

• Focusing on non-verbal behavior patterns in face-to-face handovers can enhance quality and reliability.
• Education and practice centered on NVB are key to improving patient care transitions.
• Understanding and applying NVB principles can mitigate risks associated with medical handovers.