Lost in translation: maximizing handover effectiveness between paramedics and receiving staff in the emergency department.

OBJECTIVE The purpose of the present study is to investigate perceptions by paramedics and hospital receiving staff about what enables and constrains handover in the ED. METHODS This is a qualitative study of interviews with 19 paramedics, 15 nurses and 16 doctors (n = 50) from ambulance services and ED in two states of Australia. RESULTS Three main themes emerged that were evident at both sites and in the three professional groups. These were: difficulties in creating a shared cognitive picture, tensions between 'doing' and 'listening' and fragmenting communication. CONCLUSION Recommendations arising from the present 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 standardized approach to handover from paramedics to ED receiving staff.