Handover tools and techniques for high-risk industries
A thorough shift handover can be the difference between a business continuing smoothly with safe work operations and an explosion (think Buncefield and Piper Alpha), reduced quality of patient care, impacted flight safety or, at the very least, disrupted workflow. Fortunately, most businesses have handover strategies in place to prevent such events. We take a look at some key handover tools and techniques (HTTs) identified in a recent study, which are used in energy production, healthcare, aviation and other industries to help staff complete efficient and effective handovers.
Standardised handover protocols
Of the 83 papers University of Southampton researchers Jediah Clark, Neville Stanton and Kirsten Revell reviewed, two-thirds discussed standardised handover protocols, such as checklists or mnemonics. These structured protocols help ensure all critical information is transmitted while reducing the risk of bias or misinterpretation. Checklists are particularly favoured by energy production and distribution operators, as just one missing detail can have disastrous consequences.
In 2005, a series of explosions at the United Kingdom’s fifth-largest oil storage depot caused the country’s “biggest peacetime blaze” — the Buncefield fire. This incident was partly caused by a lack of handover structure and miscommunication about which pipeline was filling the tank, according to the study. As a result, checklists are used to cover handover-related risk factors, ensure that all information related to previous, current and future work has been included and that all physical inspections have been completed prior to takeover.
Importantly, these checklists should be tailored to specific industries and workplaces to ensure workers can efficiently pass on the most relevant information. Conversely, the medical industry uses the mnemonic ‘SBAR’ (situation, background, assessment and recommendation) to help incoming staff understand previous events, the rationale behind certain actions and allow them to treat patients effectively after the handover. In both cases, the researchers warn against relying too heavily on standardisation as it could result in a bias towards one-way transmission of information. Additionally, rigid checklists could result in important, contextual information being left out.
While energy production and aviation often have predictable information types, other industries — like health care — need to be able to adapt to different patient statuses, needs and requirements, meaning they need a more flexible handover procedure. SBAR is good for this, as it allows staff to pass on information about patients’ unique conditions. However, a more rigid framework could prevent this sort of information from being transmitted and any deviation from the framework could result in criticism. Therefore, the researchers suggest that employers should favour HTTs that suit industry and local needs.
Two-way, verbal and face-to-face communication
Two-way communication is also identified as critical for ensuring information is transmitted and received accurately and effectively. Instead of passively receiving information, the incoming staff member now has an opportunity to engage with their outgoing colleague, ask questions and clarify information. This may be done verbally — allowing workers to access key information more readily than through written documents — or non-verbally through gestures — as is allowed during face-to-face interactions.
Review of past information
Knowledge of previous events can also help operators understand current and future practices and goals, particularly in energy production and air traffic control rooms. According to the researchers, 12 of the 14 energy production-related papers analysed mentioned reviewing logs as a top priority during handover. This helps prevent incidents such as the Buncefield fire or the 1988 Piper Alpha explosion, which was partly attributed to a failure to inform incoming staff about a removed release valve from a condensate pump during changeover. The next shift had an issue with a second condensate pump and restarted the (unbeknownst to them) compromised pump, giving way to the resulting explosions, according to the study.
Reviewing logs also acts a safety net so people can access information that might not have been transmitted verbally during the handover and is in the system for future reference. However, personalised logs and notes can be under-structured. To help workers access pertinent information most effectively, the researchers suggest businesses should employ more structured logs and run trials to assess their effectiveness.
Training employees to implement a structured handover has been shown to be an effective HTT. Here, employers might provide guidance on an implemented structured tool, work to enhance communication skills, build trust between staff members and simulate handover scenarios. This approach has been used in healthcare through the ‘HELiCS programme’ — where staff developed their handover communication by watching and analysing video playback of real-time scenarios.
Technology plays a central role in team communication. Videoconferencing, file sharing, networked radios and program sharing can be used to exchange information and raise workers’ situation awareness in any industry.
Preparation and adaptation of task and handover setting
Timing and location can be the difference between workers being focused and prepared or distracted and flustered for the coming shift.
Noise or staff interruptions can reduce the effectiveness of information transmission. To prevent this — at least in a healthcare setting — some studies have called for a standardised handover location that ensures staff have access to data systems and are kept away from distractions. Setting time aside for handovers gives workers time to prepare, check records and review materials. In energy production, handover timetables can help ensure that no attention-critical events are managed during shift change. Early arrival can also help ensure handover goes smoothly.
Extra handover time may also be allocated if incoming staff have been absent for a longer period of time.
Compatible mental models
Getting on the same page takes more than information sharing. To properly synchronise goals and establish a narrative, workers need to relate information to their tasks, the environmental layout and its tempo (where they were, where they are, where they are going and at what pace). This representation is known as a ‘mental model’. An accurate mental model not only ensures workers understand the workplace’s situation but also allows them to see problems in a new light and explore alternative approaches to solving them.
Other HTTs outlined in the study include:
- having staff repeat information back to the outgoing worker;
- clarifying control — this might be more helpful in an aviation setting where crews will both acknowledge transition of control;
- creating a culture of shared responsibility;
- multimedia use;
The study was published in the October 2019 issue of Safety Science.
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