Exploration of handover communication in military and NHS emergency care settings

There is an emerging body of literature on handover communication in civilian emergency care settings between paramedics and hospital receiving staff. However, little is known about how handover is conducted in the UK military and how this might differ from the NHS. The aim of this study was to explore the handover experiences of paramedics who have worked in both organisations in order to learn more about handover communication. The key objectives were to gain further insights into how these experiences changed paramedics’ expectations and knowledge of handover, and how they managed the transition between different emergency care settings.The study was informed by a mixed methods approach. It used semi structured interviews with paramedics who have worked in the NHS and with the Medical Emergency Response Team (MERT). Data from interviews was recorded, transcribed, and organised using Computer Assisted Qualitative Data Analysis (CAQDA). The study was supplemented by reflexive diary entries of handover communication and includes contemporaneous notes, drawings and reflections on handover.The study showed that there were differences between handover communication in the military and the NHS, and these were driven by organisational culture and mission, patient characteristics, training of health care professionals, and available resources. However, standardisation was a common feature in both emergency care settings. In the military, the ATMIST mnemonic was a key element of standardisation, whilst in the NHS this was driven by the Patient Report Form (PRF). It appeared that transition between different healthcare settings, especially from the military to the NHS, was challenging for paramedics. More research is needed into how paramedics manage these transitions and how they can be supported through this process