Team Resource Management at handover

Team resource management is defined as the use of strategies to best utilise all available resources including information, equipment and people to optimise the safety and efficiency of a team. Initially these were skills focused on in the aviation industry but they have been adopted by medical teams. Team resource management considerations optimise the safe passage of information during handover, ensuring that the whole team has all the relevant information before the pre-hospital team leaves.

As the pre-hospital team, a single team member should deliver a structured, 60 second handover, facing the receiving team and encouraging questions on completion of ATMIST and again at the end of AMPLE. The treating pre-hospital clinician should be with the patient during handover. The handover details should be reviewed prior to arrival. Some services have utilised the use of a structured service wide system to avoid the need to jot notes down on gloves or back of hands. Fitzpatrick et al showed the use of an ATMIST handover slate given to all members of an ambulance service was a simple solution that improved handover technique and user satisfaction.

As the receiving team, the trauma team leader needs to ensure the whole team is present for handover, listening and not distracted by the patient or other tasks. The team leader should identify themselves and ensure the team understand this will be a hands-off handover. The term hands off, eyes on provides the instructions for the 60 second period when the patient remains on the trolley to facilitate handover. The handover information should be captured contemporaneously. The handover should be interruption free but with questions asked between the ATMIST and AMPLE handovers.

Learning bite

• Handover should aim to be hands-off.
• A structured handover should take 60 seconds.
• As a trauma team leader, team resource management skills need to be practiced.