Design and trial of a new ambulance-to-emergency department handover protocol: 'IMIST-AMBO'

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dc.contributor.author Iedema, R
dc.contributor.author Ball, C
dc.contributor.author Daly, B
dc.contributor.author Young, J
dc.contributor.author Green, T
dc.contributor.author Middleton, PM
dc.contributor.author Foster-Curry, C
dc.contributor.author Jones, M
dc.contributor.author Hoy, S
dc.contributor.author Comerford, D
dc.date.accessioned 2014-04-03T01:26:13Z
dc.date.issued 2012-08
dc.identifier.citation BMJ Quality and Safety, 2012, 21 (8), pp. 627 - 633
dc.identifier.issn 2044-5415
dc.identifier.other C1 en_US
dc.identifier.uri http://hdl.handle.net/10453/23369
dc.description.abstract Background: Information communicated by ambulance paramedics to Emergency Department (ED) staff during handover of patients has been found to be inconsistent and incomplete, and yet has major implications for patients' subsequent hospital treatment and trajectory of care. Aim: The study's aims were to: (1) identify the existing structure of paramedic-to-emergency staff handovers by video recording and analysing them; (2) involve practitioners in reflecting on practice using the footage; (3) combine those reflections with formal analyses of these filmed handovers to design a handover protocol; (4) trial-run the protocol; and (5) assess the protocol's enactment. Method: The study was a 'video-reflexive ethnography' involving: structured analysis of videoed handovers (informed by ED clinicians' and ambulance paramedics' comments); ED clinicians and ambulance paramedics viewing their own practices; and rapid atwork training and feedback for paramedics. A five-question pre- and post-survey measured ED triage nurses' perceptions of the new protocol's impact. In total, 137 pre- and post-handovers were filmed involving 291 staff, and 368 staff were educated in the use of the new protocol. Results: There was agreement that Identification of the patient, Mechanism/medical complaint, Injuries/information relative to the complaint, Signs, vitals and GCS, Treatment and trends/response to treatment, Allergies, Medications, Background history and Other (social) information (IMIST-AMBO) was the preferred protocol for non-trauma and trauma handovers. Uptake of IMIST-AMBO showed improvements: a greater volume of information per handover that was more consistently ordered; fewer questions from ED staff; a reduction in handover duration; and fewer repetitions by both paramedics and ED clinicians that may suggest improved recipient comprehension and retention. Conclusion: IMIST-AMBO shows promise for improving the ambulance-ED handover communication interface. Involving paramedics and ED clinicians in its development enhanced the resulting protocol, strengthened ED clinicians' and ambulance paramedics' sense of ownership over the protocol and bolstered their peers' willingness to adopt it.
dc.language eng
dc.relation.isbasedon 10.1136/bmjqs-2011-000766
dc.title Design and trial of a new ambulance-to-emergency department handover protocol: 'IMIST-AMBO'
dc.type Journal Article
dc.description.version Published
dc.parent BMJ Quality and Safety
dc.journal.volume 8
dc.journal.volume 21
dc.journal.number 8 en_US
dc.publocation London en_US
dc.identifier.startpage 627 en_US
dc.identifier.endpage 633 en_US
dc.cauo.name FASS.Faculty of Arts and Social Sciences en_US
dc.conference Verified OK en_US
dc.for 2001 Communication and Media Studies
dc.personcode 100638
dc.personcode 109842
dc.percentage 100 en_US
dc.classification.name Communication and Media Studies en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US
dc.date.activity en_US
dc.location.activity en_US
pubs.embargo.period Not known
pubs.organisational-group /University of Technology Sydney
pubs.organisational-group /University of Technology Sydney/Faculty of Arts and Social Sciences
pubs.organisational-group /University of Technology Sydney/Strength - Research in Learning and Change
utslib.copyright.status Closed Access
utslib.copyright.date 2015-04-15 12:17:09.805752+10
pubs.consider-herdc true
utslib.collection.history Uncategorised (ID: 363)
utslib.collection.history Closed (ID: 3)


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