Allied Health Clinical Handover (Back to the Bush)

WACHS Allied Health Reference Group received funding via the SQUIRE quality and safety initiative to investigate clinical handover issues between metro and rural allied health professionals.   External consultants, Next Challenge, were contracted to undertake the project, which was completed 30th June 2009.

The project involved a comprehensive literature review and interview with allied health professionals across WACHS health sites and metropolitan tertiary hospitals.  Whilst, due to time contraints, the project involved interview of only PTs and OTs, the project is relevant and has significant findings for all allied health professions.  It is anticipated that the outcomes of this project is transferable other allied health professions and allied health handover contexts (e.g. general hospitals, community services etc).

FINAL REPORT - Back to the Bush:  Allied Health Clinical Handover Project

Project Recommendations

• Adapt the iSoBAR tool for clinical handover specific to allied health professionals needs and contexts.
• Establish minimum standards for the handover process including type of handover, content of handover, timeframes and expectations (limitations) (see Preliminary tool suggestions section).
• Standard clinical handover policy and guidelines including the purpose, minimum standards and reporting strategies for reciprocal clinical handover between rural and metropolitan services.
• Develop a decision-making framework to guide clinical handover with regard to above element.
• At a minimum, clinical handover to be provided in written format directly the receiving clinician (fax or email) and will include the direct contact details of the referring clinician.  Phone contact should accompany the written referral.
• Improve communication process and feedback by the receiving health professional, including confirmation of receipt of handover, provision of outcome and problem identification information, feedback on suitability of expectations etc.
• Increase awareness and utilisation of incident reporting systems, including AIMS, for the report, feedback and management of incidents relating to clinical handover.
• Develop education resources to support knowledge required for clinical handover, including 
  • Rural and remote service provision
  • Geography and environmental of country WA (including issues related to outreach service provision where the client away from the health professional base)
  • Capacity and capabilities of rural and remote health services
  • Targeted client groups such as Aboriginal people
• Establish, enhance, market and maintain current contact detail resources.
• Further investigate strategies to support clinical handover for high-risk populations such as Aboriginal clients, clients from remote communities and non-standard housing situations and shared care paediatric clients.