Safety in the transition between shifts - A qualitative study within healthcare

This paper explores the relationship between shift handover practice and safety. The objective of the paper is to describe how shift handover is practiced in a local work setting characterized by complexity and risk, to de-termine important influencing factors, and to explore how shift handover quality may influence safety. A qualitative case study was designed within the specialized health services, covering two different shift handover practices within two different wards at a regional hospital. Results from the case study show that shift handover practices at a hospital are complex work processes. Factors influencing the handover practice were identified and grouped in internal conditions (information amount, individual communication skills, and experience) and external conditions (handover time frame, interruptions, ward size/ patient capacity, and patient type). Most informants did not themselves perceive shift handover practice as a risk factor. Neverthe-less, most informants perceived the quality of the observed shift handovers as insufficient due to factors such as handover time frame, ward size/ patient capacity, interruptions, and individual communication skills. In our interpretation, the factors that affect the quality of the shift handover negatively may have short- and long-term effects on safety.