Retention of information by emergency department staff at ambulance handover: do standardised approaches work?

Background: Ambulance crews usually have just one opportunity to convey information about their patients to emergency department (ED) personnel. ED staff receiving patients from ambulance crews will naturally be focussed on their own initial assessment of the patient, which often distracts them from listening carefully to the ambulance crew's handover. Important information may be lost after the ambulance crew leaves. Methods: Current handover practice was evaluated in two large EDs. A structured DeMIST format for verbal handover of pre-hospital information from the ambulance crew to receiving ED staff was then introduced into one of the departments. The number of packets of information in each verbal handover and the accuracy of ED staff's recall was assessed. Results: 56.6% of the information given at verbal handover by the ambulance crews was accurately retained by ED staff before the introduction of DeMIST. Only 49.2% of the information given at verbal handover by the ambulance crews in the DeMIST format was accurately retained by ED staff. Discussion: Communications training, clinical team leadership and team discipline must support the communication process between ambulance crews and the ED team to ensure that important pre-hospital information is not lost or misinterpreted. Electronic patient report forms are currently under development and may provide a partial solution for the transfer of accurate pre-hospital information to ED staff.