Improving JMO clinical handover at all shift changes - ARCHI

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ContentsAt a glance...........................................................................................................................................................................3Why we must change.........................................................................................................................................................5Key elements for implementation.....................................................................................................................................61. A communication framework to facilitate clinical handover at JMO shift change (ISBAR) .............................................62. Senior leadership: deciding who and what to hand over at shift change.......................................................................73. Shift to Shift handover: key principles for locally appropriate implementation...............................................................93.1 Handover Happens...............................................................................................................................................103.2 Handover Leadership............................................................................................................................................103.3 Handover Set-up..................................................................................................................................................113.4 Handover Process.................................................................................................................................................12Appendices........................................................................................................................................................................ 13A. A clear case for change (QSA data, literature, JMO perspectives)................................................................................13B. Wider issues that require consideration (wider implementation for other junior doctors, rostering).............................14C. Points to consider for implementation across 24 hours...............................................................................................16D. Clinical information to consider when handing over a patient....................................................................................17E. Implementation framework to assist facilities with JMO clinical handover...................................................................20F. Implementation support (templates, tools and links to guide implementation of JMO clinical handover at facilities)........22G. Prevocational training networks in NSW.....................................................................................................................26Useful references.............................................................................................................................................................. 27Acknowledgements..........................................................................................................................................................282 NSW Health Improving JMO clinical handover – Implementation Toolkit
At a glanceBetween the Flags (PD2010_026) and Safe Clinical Handover (PD2009_060) are two important mandates inthe NSW health system that place a strong focus on effective and early clinical communication of changes topatient condition.This document aims to assist facilities to implement locally appropriate clinical handover processes at all Junior MedicalOfficer (JMO) shift changes, improving the consistency and quality of clinical communication for better patient outcomes.Both junior and senior medical officers, with metropolitan and rural representation, have collaborated in the writing of thisdocument to ensure that it meets their needs.Clinical handover definitionClinical handover has a nationally and internationallyrecognised definition.‘…transfer of professional responsibility andaccountability for some or all aspects of carefor a patient, or group of patients, to anotherperson or professional group on a temporaryor permanent basis.’ 1,3,10.In your facility, does JMO clinicalhandover:• happen at all shift changes?• have a consistent process?• promote quality clinical communication?• improve patient care outcomes?Three key elements have been definedto help improve JMO clinical handover1 A communication framework for JMOs (ISBAR).A communication framework using a minimum dataset to guide clinical handover can ensure consistentand complete, yet concise, handover interactions.– Detail on the ISBAR communication frameworkcommences page 6.2 Senior leadership: who and what should behanded over?All JMOs require leadership and supervision frommore senior clinicians (eg Registrars, Consultants) todetermine which patients and what information havethe greatest priority for handover.– Detail on senior leadership at handover commencespage 7.3 Shift to shift handover: key principles for locallyappropriate implementation.JMO clinical handover processes must be appropriateto local needs and appropriate to the specific shiftchange (day, evening or night and on weekends).All facilities have the flexibility to determine locallyappropriate processes, but need to ensure that thoseprocesses (day, evening and night) meet a set of keyprinciples.– Detail on the key principles commences page 9.But wait… who is a JMO?For the purpose of this document, a JMO is defined as amedical officer who is a part of the prevocational trainingprogram of the NSW Clinical Education and TrainingInstitute (CETI, formerly IMET):• Australian medical school postgraduates,Year 1 and Year 2 and• Australian Medical Council graduates,Year 1 and Year 2.There is a broader intention tothe program.All facilities are encouraged to consider how the keyelements of the JMO shift handover project can betransferred or tailored to other ‘junior’ doctors and otherscenarios of handover (eg handover between medicalteams or transfer between facilities or the community).NSW Health Improving JMO clinical handover – Implementation Toolkit 3
Page 2 and 3: NSW DEPARTMENT OF HEALTH73 Miller S
Page 8 and 9: Key elements for implementation1. A
Page 10 and 11: • Senior Medical Officers involvi
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Page 15 and 16: AppendicesAppendix AA clear case fo
Page 17 and 18: The implementation of structured an
Page 19 and 20: Appendix DClinical information to c
Page 21 and 22: Most of the fundamental information
Page 23 and 24: The framework below is a framework
Page 25 and 26: Existing guides:IMPLeMeNTATION TOOL
Page 27 and 28: CD and Video supportJMO clinical ha
Page 29 and 30: Useful referencesThe JMO clinical h
Page 31 and 32: The Acute Care Taskforce tested all
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Improving JMO clinical handover at all shift changes - ARCHI

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