Plus-Hex CLINICAL
Conclusions
Handovers are complex and have a number of potential pitfalls, which may result in patient harm. Although communication skills form part of veterinary professionals’ training, the focus is often on communication in relation to client relationships. Interprofessional communication, including handover skills, requires specific training that considers environmental and systemic factors.
Standardised handover systems, particularly I-PASS, have the potential to reduce medical error rates and improve efficiency. Despite the potential barriers to implementing such a system, the author has successfully implemented I-PASS in her current practice, with an overwhelmingly positive response.
Assessment of learning
1. What does the‘ A’ in I-PASS stand for? a) Action list b) Aims c) Anticipated complications 2. What does closed-loop communication ensure? a) A break before the next patient b) The handover is quieter c) Accurate comprehension 3. What is a leading cause of medical errors? a) Misspelling b) Communication failures c) Staffing failures
Acknowledgements
1. a) Action list 2. c) Accurate comprehension 3. b) Communication failures
Answers
The author would like to thank her clinical director at Paragon Referrals for encouraging her, and the nursing team at Paragon Referrals for engaging with the development and implementation of the new handover system.
REFERENCES
1 Royal College of Veterinary Surgeons. RCVS Day One Competences, Skills and Professional Behaviours for Veterinary Nurses: Introduction. 2014. Available from: https:// www. rcvs. org. uk / setting-standards / accrediting-primary-qualifications / accrediting-veterinarynursing-qualifications / rcvs-day-one-competences-skills-andprofessional-behaviours-for / [ Accessed 10 June 2022 ].
2 Royal College of Veterinary Surgeons. RCVS Day One Competences. 2022. Available at: https:// www. rcvs. org. uk / news-and-views / publications / rcvs-day-one-competences-feb-2022 / [ Accessed 27 May 2025 ].
3 Gray CA, Blaxter AC, Johnston PA, Latham CE, May S, Phillips CA, et al. Communication education in veterinary education in the United Kingdom and Ireland: the NUVACS project coupled to progressive individual school endeavors. Journal of Veterinary Medical Education. 2006; 33( 1): 85 – 92. Available from: https:// doi. org / 10.3138 / jvme. 33.1.85.
4 Mossop L, Gray C, Blaxter A, Gardiner A, MacEachern K, Watson P, et al. Communication skills training: what the vet schools are doing. Veterinary Record. 2015; 176( 5): 114 – 117. Available from: https:// doi. org / 10.1136 / vr. h425.
5 Russell E, Mossop L, Forbes E, Oxtoby C. Uncovering the‘ messy details’ of veterinary communication: an analysis of communication problems in cases of alleged professional negligence. Veterinary Record. 2021; 190( 3): e1068. Available from: https:// doi. org / 10.1002 / vetr. 1068.
6 Shaw JR. Evaluation of communication skills training programs at North American veterinary medical training institutions. Journal of the American Veterinary Medical Association. 2019; 255( 6): 722 – 733. Available from: https:// doi. org / 10.2460 / javma. 255.6.722.
7 Dinsmore JR. Veterinary lawsuits: trends and defense strategies. Veterinary Clinics of North America: Small Animal Practice. 1993; 23( 5): 1019 – 1026. Available from: https:// doi. org / 10.1016 / s0195- 5616( 93) 50133-x.
8 Nunalee MMM, Weedon GR. Modern trends in veterinary malpractice: how our evolving attitudes toward nonhuman animals will change veterinary medicine. Animal Law Review. 2004; 10( 1): 125 – 161. Available from: https:// lawcommons. lclark. edu / alr / vol10 / iss1 / 8 / [ Accessed 27 May 2025 ].
9 Corah L, Mossop L, Cobb K, Dean R. Measuring the success of specific health problem consultations in cats and dogs: a systematic review. Veterinary Record. 2018; 183( 1): 22. Available from: https:// doi. org / 10.1136 / vr. 104759.
10 Manser T. Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiologica Scandinavica. 2009; 53( 2): 143 – 151. Available from: https:// doi. org / 10.1111 / j. 1399-6576.2008.01717. x.
11 Weller J, Boyd M, Cumin D. Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgraduate Medical Journal. 2014; 90( 1061): 149 – 154. Available from: https:// doi. org / 10.1136 / postgradmedj-2012-131168.
12 Blazin LJ, Sitthi-Amorn J, Hoffman JM, Burlison JD. Improving patient handoffs and transitions through adaptation and implementation of I-PASS across multiple handoff settings. Pediatric Quality & Safety. 2020; 5( 4): e323. Available from: https:// doi. org / 10.1097 / pq9.0000000000000323.
13 Rhind SM, Baillie S, Kinnison T, Shaw DJ, Bell CE, Mellanby RJ, et al. The transition into veterinary practice: opinions of recent graduates and final year students. BMC Medical Education. 2011; 11: 64. Available from: https:// doi. org / 10.1186 / 1472-6920-11-64.
14 Shekelle PG, Pronovost PJ, Wachter RM, McDonald KM, Schoelles K, Dy SM, et al. The top patient safety strategies that can be encouraged for adoption now. Annals of Internal Medicine. 2013; 158( 5 Pt 2): 365 – 368. Available from: https:// doi. org / 10.7326 / 0003-4819-158-5-201303051-00001.
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