Affect, Materiality and the Clinical Handover: Studies at a Children's Hospital

West Midlands
Start Date: 1 Jan 2014

Project summary

In 2013, a team of medical, nursing and management professionals at Birmingham Children's Hospital (BCH) gained funding support from the Health Foundation to increase the safety of handovers between their day and night clinical services across the hospital. Since legal changes to the hours people can work were put in place in hospitals from 2009, a hospital-wide service has been co-ordinating and delivering services for the children and young people receiving treatment and care at night. The Hospital @ Night (H@N) team attends and participates in a comprehensive handover every evening as they commence their work, and then hands over to clinical specialty-based staff every morning.Information had been collected which showed that these handovers were too long, complex, poorly organised and were implicated in avoidable errors in patient care. However, new understandings of and approaches to handover have been developed in many hospital settings. An exciting development in the US has offered a new format for handover. Early indications have suggested that this has made a positive contribution to patient safety and quality in a leading US Children's Hospital. Experts advising the team at BCH helped to devise a package which built upon the successes in the US. Three new elements were introduced: an electronic handover system; a new handover tool/framework which encourages increased awareness of relevant information; and, a new online training package to support staff. With support from the dedicated team at BCH attempts have been made to introduce this package across the hospital. However, to date, only the electronic handover system has been successfully implemented. It isn't entirely clear why this has occurred.This doctoral study aims to examine the introduction of new and safer ways of working by clinical staff such as doctors and nurses at Birmingham Children's Hospital (BCH). In particular, one focus will be upon attempts to support staff in becoming and remaining aware of their working environment. In the hospital setting, this is especially important where some information may not seem important at the time it emerges and might otherwise be overlooked or disregarded. There is published research evidence that organisations such as hospitals, which operate in the face of high levels of risk and uncertainty, should develop a range of approaches to becoming more mindful of a wider array of information in support of safety.The study will gather data from observations of and interviews with key staff members. Documentary evidence will also be collected. Analysis of this data will afford opportunities to gain deeper understanding of the introduction and implementation of patient safety innovations in UK hospital settings.

Simon Blake