Improving measurement in clinical handover

Background: Poor clinical handover creates discontinuities in care leading to patient harm. However, the field of handover research continues to lack standardised definitions and reliable measurement tools to identify factors that would lead to harm reduction and improved safety strategies. Objective: This paper introduces a conceptual framework to underpin a research agenda around the important patient safety topic of clinical handover. Methods: Five frameworks with potential application to clinical handover were identified in a consultation process with clinicians, researchers and policy makers. Results: The framework consists of three key handover elements-information, responsibility and/or accountability and system-in relation to three key measurement elements-policy, practice and evaluation. Using this framework an analysis of current "gaps" in the measurement of handover was completed. Conclusion: The paper argues that measurement will identify gaps in knowledge about handover practice and promote rigor in the design and evaluation of interventions to reduce patient harm.