• Francesco Dojmi Di Delupis, Paolo Pisanelli, Giovanni Di Luccio, Maura Kennedy, Sabrina Tellini, Nadia Nenci, Elisa Guerrini, Riccardo Pini, and Franco GensiniGianG.
• Inter-institutional Integrated Department, University of Florence and Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy, francescodojmi@yahoo.it.
• Intern Emerg Med. 2014 Aug 1; 9 (5): 575-82.

AbstractCommunication failures in the pre-hospital/hospital interface have been identified as a major preventable cause of patient harm. This interface has not adequately been studied in Italy. In this study, we: (1) evaluated the communication of pre-hospital and hospital providers during handover through the analysis of simulation sessions; (2) identified the critical information that should be routinely communicated during handover with a survey administered to emergency triage nurses; (3) measured communication within this interface through the adaptation of an existing tool from a multidisciplinary focus group; (4) validated the adapted tool with the inter-rater agreement of physicians who reviewed video recordings from multidisciplinary simulations sessions; and (5) developed a handover training for pre-hospital providers and evaluated the communication improvement between pre- and post-training. In our simulations we found an absence of standardization of the handover communication process, marked variability in information communicated, and a lack of formal transfer of responsibility of patient care. We adapted existing handover communication tools for local use and developed a checklist for the evaluation of handover communication that had good inter-rater reliability. Lectures coupled with high-fidelity simulation exercises on handover did result in a statistically significant improvement in handover communication.

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