A dramaturgical analysis of a paediatric team handover

Introduction: The paediatric team handover process is a crucial workplace practice and comprises the transfer of patient information from one shift to another involving medical professionals and students. A qualitative study was performed to analyse the feasibility, functionality, benefits and limitations of the dramaturgical approach when applied to examining a handover session. Methods: Data relating to one handover were collected and analysed from video and audio recordings, notes created by two independent observers and a de-identified copy of the handover sheet. Results: The dramaturgical constructs and subsequent findings allowed us to make informed inferences about the dynamics of the handover procedure. The directors/lead actors consisted of a consultant and a registrar. One consultant was transitory and the remaining 12 attendees were either major support, support or bit actors. The students (bit actors/audience) were included when a learning point was emphasised. The script was informal and improvised as the discussion emphasised certain facets of patient care or accentuated learning points. The staging involved the seating arrangement, a whiteboard, computer screen and ongoing data presentation. The performance suggested a handover of two halves: one emphasising learning and the other allocation of patient care responsibility. Conclusion: We concluded that the real-life drama occurring within a handover was feasibly analysed, with its functionality demonstrated, using the dramaturgical investigative system. The multifaceted recordings enabled researchers to review the ‘authentic’ handover system without censorship. These findings have implications for educational and organisational research.

Trends of Human-Robot Collaboration in Industry Contexts: Handover, Learning, and Metrics

Repetitive industrial tasks can be easily performed by traditional robotic systems. However, many other works require cognitive knowledge that only humans can provide. Human-Robot Collaboration (HRC) emerges as an ideal concept of co-working between a human operator and a robot, representing one of the most significant subjects for human-life improvement.The ultimate goal is to achieve physical interaction, where handing over an object plays a crucial role for an effective task accomplishment. Considerable research work had been developed in this particular field in recent years, where several solutions were already proposed. Nonetheless, some particular issues regarding Human-Robot Collaboration still hold an open path to truly important research improvements. This paper provides a literature overview, defining the HRC concept, enumerating the distinct human-robot communication channels, and discussing the physical interaction that this collaboration entails. Moreover, future challenges for a natural and intuitive collaboration are exposed: the machine must behave like a human especially in the pre-grasping/grasping phases and the handover procedure should be fluent and bidirectional, for an articulated function development. These are the focus of the near future investigation aiming to shed light on the complex combination of predictive and reactive control mechanisms promoting coordination and understanding. Following recent progress in artificial intelligence, learning exploration stand as the key element to allow the generation of coordinated actions and their shaping by experience.

On-call handover ‘– if it isn't documented then it didn't happen’

Aims1. To standardise the doctor handovers for on-call duties2. To ensure there is documented evidence of handover taking place at the end of each shiftBackgroundSince the introduction of the European working time directive the amount of hours that doctors are allowed to work has been reduced, resulting in increased handovers between teams. The National Patient Safety Committee and General Medical Council have recognised that this means we need to ensure handovers are as safe and robust as possible to ensure that patient safety is not compromised. A recent serious investigation report carried out at Chase Farm Hospital, London identified a lack of formalised handover between doctors as a contributing factor leading to patient harm. One of the recommendations of the report was for a Quality Improvement Project to be carried out in order to formalise handover.The handover procedure at Chase Farm Hospital for core trainee doctors 'on-call' prior to this QIP was not standardised and consisted of an informal, verbal handover. Frustrations had been raised by doctors and other staff members that this current method of handover was unreliable and unsafe.MethodWe sent out a questionnaire about handover to all doctors on the on-call rota to help establish what intervention would be appropriate.We then performed a retrospective collection of documented handovers within a two month time period.Our intervention was to introduce an email handover procedure.Following a two month trial of this intervention, we resent the questionnaire and performed a second retrospective collection of handover documentation.ResultPrior to this QIP we found that 0% of on call handovers were being formally documented. After the introduction of our handover email 88% of handovers were being formally documented using the handover email.Satisfaction with the handover procedure went from 0% being very satisfied and only 33% being satisfied to 50% being satisfied and 50% being very satisfied.ConclusionA standardised and documented handover procedure is crucial for patient safety and to allow doctors to communicate jobs effectively with each other.A secure email for handover is a successful way of formalising the handover process.Limitations include:Access to the handover email for new staff or locum staff.Ensuring that doctors who aren't on the on-call rota know how to use it to handover their ward jobs.