Plus-Hex CLINICAL
Introduction
Handovers, also referred to as handoffs, occur across veterinary care in both general and referral practices. They allow the transfer of information such as patient information, nursing goals and interventions. However, inconsistent communication styles, and systemic and environmental factors, can cause handovers to compromise patient safety.
Like many veterinary practices, the author ' s practice reports errors and near misses, and the clinical governance team anecdotally believes that communication errors underpin many of the reports.
As the ward team leader, the author recognised that handovers were a potential factor in many medical errors. Before intervention, handovers predominantly occurred at the kennel side, but the style of communication varied, and handovers had no specific structure or style. During her investigation, team members reported that handovers were lengthy and often stressful, with numerous distractions.
This article explores the research on communication specifically relating to handovers, and proposes a standardised approach, with details of how such an approach has been implemented at the author ' s practice, in response to her findings.
Learning outcomes
• Recognise how handover systems can impact on patient safety
• Appraise the use of a standardised handover system
• Appreciate the barriers to changing communication styles in clinical practice
Communication
Communication skills are universally recognised as essential for veterinary nurses( VNs) and veterinary surgeons( VSs), and are embedded within the respective RCVS Day One Competences [ 1, 2 ]. It has been reported that communication skills training is now included in all undergraduate veterinary curricula across the UK [ 3, 4 ].
However, a mixed-methods study in 2021, investigating alleged veterinary negligence cases, determined that communication played a contributory role in 80 % of cases [ 5 ]. The study highlighted the interdependence of communication events with the context, system and environment in which they occur [ 5 ]. The conclusions of the study pose a statement for consideration: effective communication is a collective competency that requires systems, rather than individuals alone, to achieve [ 5 ].
Until now, most veterinary studies have focused on how communication affects client satisfaction and business outcomes [ 6 – 8 ], with few identifying an impact on patient safety, perhaps because it is difficult to quantify [ 9 ]. A recent veterinary study [ 5 ] found that in 57 % of the cases investigated, communication contributed to mistakes in the delivery of care, and over half of the communication problems identified occurred within the veterinary team rather than with the client. These findings suggest a need for an increased focus on team communication and its impact on patient outcomes [ 5 ].
In human healthcare, communication failures are recognised as a leading cause of medical errors [ 10, 11 ], and half of the communication failures have been found to occur during patient handovers [ 12 ]. Although communication skills are taught in veterinary medicine, this rarely includes formal handover training [ 13 ].
Team training in human healthcare has been a priority strategy [ 14 ], following the success of other professions and industries, such as aviation, in implementing non-technical skills training [ 15 ]. More specifically, interventions that allow teams to better understand how they communicate in their own context have been thought to have the potential to generate improved communication [ 5 ].
One intervention that has been extensively researched in the context of healthcare is the concept of a structured patient handover. Structured handovers are thought to improve communication, increase clinicians ' comfort, improve the retention of patient information and improve patient safety [ 16, 17 ].
Introducing I-PASS
Many structured handover systems exist, but I-PASS has emerged as the most dominant in human healthcare. This system is specifically designed for healthcare applications and has been extensively validated in research [ 17 – 23 ].
I-PASS is a mnemonic consisting of five components: Illness severity, Patient summary, Action list, Situation awareness and contingency planning, and Synthesis by receiver [ 19 ]. Its structure allows the handover provider to exchange relevant information concisely [ 12 ], ensuring that anticipated problems are conveyed. The closed-loop style of communication allows the receiver to synthesise the information, with a brief‘ read back’ to ensure accurate comprehension of the information they have been given [ 24 ]. This method of reading back critical information has been adapted from other settings, such as aviation and the military, where it has been used reliably [ 24 ].
The statistics speak for themselves, particularly those from a rigorous, multi-centre human study evaluating the effect of the handover system on paediatric patient safety [ 17 ]. There was a 23 % reduction in medical errors
Volume 40( 4) • August 2025
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