Public hospitals currently face an ever increasing demand on their resources, and there are many attempts at streamlining processes and patient flows. However, in many cases, optimizing processes is not enough, as ‘soft’ factors such as the relationships between hospital wards influence how efficiently the resources needed to treat patients are utilized. These factors are often ignored when attempting to improve patient flows. In this chapter, the authors describe a case study investigating the relationships between an acute stroke ward and a specialist stroke rehabilitation ward of a large metropolitan health service. The motivation for this study was the hospital management’s interest in improving communication and collaboration across wards as a means to optimize hospital processes, and thus, patient care. To assess the relationships between the two wards, the authors examined the patient handover process that links the wards’ activities and applied the Trust-Confidence-Distrust (TCD) framework of Gans et al. (2003), which was developed to model trust relationships in social networks, to examine the trust relationships between the wards.
Standardised proformas improve patient handover: Audit of trauma handover practice