Understanding how clinical judgement and communicative practices interact with the use of an electronic clinical handover system

Clinical handover is a high risk scenario involving the transfer of information, responsibility and accountability for patient care. Many strategies have been proposed to improve clinical handover and reduce risks it can pose to the safety and quality of patient care. The development and implementation of electronic tools provides one mechanism for structuring and streamlining information transfer to support more standardised handover practices. However, clinical judgement remains a valued, fundamental aspect of clinical practice and its communication during handover is open to variation in ways that may compromise patient safety. This research examines these issues based on evidence generated from a user-centred approach involving clinicians in the development and implementation of an electronic clinical handover system. The paper highlights how clinical judgements and communicative practices interact with an electronic clinical handover system, and discusses their potential implications for patient safety as part of a broader clinical handover improvement project.