References
Clinical handover between paramedics and emergency department staff: SBAR and IMIST-AMBO acronyms
Abstract
Clinical handover at the paramedic/emergency department (ED) interface is a potentially critical episode in the patient care journey, as omission of information can adversely affect subsequent actions and the treatment provided in the ED. Standardisation of the handover contents and processes has shown to prevent errors and omissions and improve the handover process. This review article explores two handover tools, SBAR* and IMIST-AMBO**, both of which have been used to standardise handover contents at the paramedic/ED interface. IMIST-AMBO provides an explicit structure to handover that is concise, complete, tailored to paramedic-ED interface, and that also aligns with the general informational expectations of ED staff. SBAR is more widely used but less specific. Further research work is needed to compare them and understand their acceptability and acceptance by different global health systems, considering environmental and cultural factors. Training requirements to ensure their respective correct implementation also need to be determined for evidence-based recommendations to be made to the various emergency services stakeholders.
Clinical handover is an integral part of the daily clinical work that takes place between paramedics and emergency department (ED) staff for every patient arriving at the hospital by ambulance or helicopter. This area of transition of care, however, has been sparsely researched (Wood et al, 2014). An ineffective handover represents a breakdown in communication of health information, which in turn may have deleterious effects on patient care and safety, including: misdiagnosis or unnecessary delays in diagnosis (Kachalia et al, 2007); delays in administration of treatment; administration of incorrect treatment or medication errors; and omission of care (Joint Commission Centre for Transforming Healthcare, 2014).
This literature review deals with the clinical handover between paramedics and ED staff (physicians and nurses), specifically focusing on two frequently used patient handover acronyms and their effectiveness and limitations in facilitating a complete, concise, and structured clinical handover. The SBAR (Situation, Background, Assessment and Recommendations) and IMIST-AMBO (Identify, Mechanism/Medical Complaint, Injuries/Information related to complaint, Signs and Symptoms, Treatment and Trends—Allergies, Medications, Background, Other information) acronyms will be explored. Given the unique requirements of each discipline, this review does not take into account the clinical handover among ED staff between shift changes or the clinical handover between ED and other hospital departments (intensive care unit, medical, and surgical floors).
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