From medical student to junior doctor: The medical handover - a good habit to cultivate

Junior doctors working in hospital medicine participate in the handover ritual most days of their working lives. Surprisingly then, this important area of medical practice receives almost no attention in the formal medical curriculum. However, with the introduction of the European Working Time Directive and the subsequent move towards shift work for junior doctors, attention has focused on the importance of communication in ensuring continuity of care.1 Handover practice has rightly been identified as a key area and has been the subject of three major reports published by healthcare regulators in the United Kingdom and Australia (see box). It is therefore timely to review what constitutes a good handover and to offer some practical suggestions on best practice.

The term handover is used to describe a variety of exchanges of information between healthcare professionals: the formal team meeting, usually held in the morning, where the night staff hand over to the day team; the transfer of information about individual patients between individual doctors which occurs when a patient is referred to another service or transferred to another ward; the briefing of after hours staff about acutely ill patients to be reviewed and other tasks that need to be done while they are on duty. While each of these situations has a particular requirement, the basic principles of good handover practice can be applied generally. The focus here will therefore be on the formal medical handover in the morning, with the acknowledgement that the principles and processes described also apply to other handover situations