1 Title of Paper: Lost in Translation: Maximising handover effectiveness

and receiving staff in the emergency department Objective: The purpose of this study is to investigate perceptions by paramedics and hospital receiving staff about what enables and constrains handover in the emergency department. Methods: This is a qualitative study of interviews with 19 paramedics, 15 nurses and 16 doctors (n=50) from ambulance services and emergency departments in 2 states of Australia. Results: Three main themes emerged that were evident at both sites and in the 3 professional groups. These were: difficulties in creating a shared cognitive picture, tensions between ‘doing ’ and ‘listening’, and fragmenting communication. Conclusion: Recommendations arising from this study as to how handover could be improved are the need for a common language between paramedics and staff in the ED; for shared experiences and understanding between the members of the team, and, for the development of a standardised approach to handover from paramedics to ED receiving staff