Clinical handover as an interactive event: Informational and interactional communication strategies in effective shift-change handovers

Authors

  • Suzanne Eggins University of Technology Sydney
  • Diana Slade University of Technology Sydney

DOI:

https://doi.org/10.1558/cam.v9i3.215

Keywords:

clinical handover communication, interactional skills in handover

Abstract

Clinical handover – the transfer between clinicians of responsibility and accountability for patients and their care (AMA 2006) – is a pivotal and high-risk communicative event in hospital practice. Studies focusing on critical incidents, mortality, risk and patient harm in hospitals have highlighted ineffective communication – including incomplete and unstructured clinical handovers – as a major contributing factor (NSW Health 2005; ACSQHC 2010). In Australia, as internationally, Health Departments and hospital management have responded by introducing standardised handover communication protocols. This paper problematises one such protocol – the ISBAR tool – and argues that the narrow understanding of communication on which such protocols are based may seriously constrain their ability to shape effective handovers. Based on analysis of audio-recorded shift-change clinical handovers between medical staff, we argue that handover communication must be conceptualised as inherently interactive and that attempts to describe, model and teach handover practice must recognise both informational and interactive communication strategies. By comparing the communicative performance of participants in authentic handover events we identify communication strategies that are more and less likely to lead to an effective handover and demonstrate the importance of focusing close up on communication to improve the quality and safety of healthcare interactions.

Author Biographies

  • Suzanne Eggins, University of Technology Sydney
    Suzanne Eggins has a BA (Hons) and PhD in Linguistics from the University of Sydney and postgraduate degrees in journalism, professional communication and applied linguistics. She taught and researched in professional writing, linguistics and children’s literature at the University of New South Wales for 15 years. She has since worked in editing and publishing and is now a health communication Research Fellow with the University of Technology Sydney. Suzanne is the author of An Introduction to Systemic Functional Linguistics (2nd edition, 2004, Continuum, London,) and is co-author of Analysing Casual Conversation (with Diana Slade, 1997, Equinox, UK).
  • Diana Slade, University of Technology Sydney
    Diana Slade is Professor of Applied Linguistics at the University of Technology Sydney. Her main research areas are the description and analysis of spoken English, workplace communication and culture particularly in healthcare settings, TESOL syllabus design and methodology and cross-cultural communication. Her PhD related research was on the analysis of English casual conversation, and her books include Conversation: From Description to Pedagogy (with Scott Thornbury, 2006, Cambridge University Press); Analysing Casual Conversation (with Suzanne Eggins, 1997, Equinox) and Minority Languages and Dominant Culture: Issues of Equity, Education and Assessment, (with Kalantzis and Cope, Falmer Press 1990).

Published

2013-09-17

Issue

Section

Articles

How to Cite

Eggins, S., & Slade, D. (2013). Clinical handover as an interactive event: Informational and interactional communication strategies in effective shift-change handovers. Communication and Medicine, 9(3), 215-227. https://doi.org/10.1558/cam.v9i3.215