Intended for healthcare professionals

Rapid response to:

Practice Essentials

Safe handover

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4328 (Published 09 October 2017) Cite this as: BMJ 2017;359:j4328

Rapid Response:

Re: Listening: a neglected aspect of safe handover

Brendan Fletcher makes a very sensible suggestion that recipients should try harder to listen and not interrupt the cognitive flow of those who are trying to hand over information about patients.

This seems to be the opposite of what we try to get doctors to do when passing information on to patients. Communication skills training suggests that we try to establish what the patient wants to know, answer those questions and fill in the gaps afterwards.

It may well be that the most important person in the process of handover is the recipient, not the giver of the information. It is she who must rapidly file information into her internal model of what is going on, to use it to deal with the situation over the next few hours. It is her cognitive processing that should be facilitated, not the story tellers. I suspect that most of you have seen students or colleagues clerking a patient and asking a question that the patient has only recently answered minutes beforehand, I suspect because the information has been given outside the listener’s readiness to process it.

What is the best, the safest way to conduct handover? I don’t know, but I do know that it should be possible to test out different models to try to answer the question of who should be in control of how the information is structured. Before we press to control handover so tightly, we should ask ourselves which methods are best for patients.

Competing interests: No competing interests

19 November 2017
I R J Thomas
GP
Kingsway Surgery, Swansea