ISOBAR Implementation for Patient Handover Between Rescue Services and Pediatric Emergency Department Staff: The...

Miscommunication is a major contributing factor to adverse events in medical care, highlighting the importance of thorough patient handover-especially in complex settings like pediatric emergency medicine. This study evaluates the effects of adopting the ISOBAR handover protocol for transfers from emergency medical services to pediatric emergency department (PED) staff.

We conducted a single-center implementation trial to evaluate the ISOBAR handover protocol's efficacy in a German university hospital's PED. The procedure was based on the previous COPTER study. We observed 107 handovers, comparing those conducted using the ISOBAR protocol with those following standard procedure without a protocol. The trial was organized into 4 consecutive phases, alternating between interventional periods. The primary outcome measure was the "Key Information Transfer Efficiency" (KITE) score. The secondary outcome measure was how PED personnel retained key information after the handover.

By the end of the study, the amount of key information transferred during the handover had increased by 22%. PED physicians remembered 16% and PED nurses 10% more key information. KITE reflected the course of the implementation. However, full adherence to the ISOBAR protocol did not have a significant effect on the outcome measures.

Although the use of ISOBAR can improve the exchange of information during handover in the PED, strict adherence to the protocol is not essential. What really matters is high-quality communication throughout the entire patient handover process.