Object

ive
Tovali
dat
ethee
ffe
cti
vene
ssofa
nit
era
tiver
efl
exi
veme
thodf
ori
nvol
vingf
ront
li
nes
taf
fini
mpr
ovi
ngha
ndove
rina
rea
sofhi
ghc
lini
calr
isk.

Design
Buil
dingonprevi
ousstudi
e susi
ngvideo-
ethnogr
aphicmethodstoi
mpr oveclinica
lproce
sse
s[1-
3],thi
sstudyprovi
dedopport
uniti
esforhea
lthcar
epr ac
tit
ione
rstovie
wa ndrefl
ectonvi
deo
foot
ageofthei
rhandoverpract
ices
.Thisenabl
edstaf
ftoidenti
fyor
ganisat
iona l
,prof
ess
iona
landenvir
onme nt
alchal
lenge
s.Usingref
lexi
vedisc
ussion,st
affdes
igne
dha ndove
rproces
ssol
u-
t
ionstoaddre
ssprobl
emsi dent
ifi
ed.Thes
es ol
uti
onswereimplemente
da nde valuat
edintwopar
ti
cipat
ingsit
es.

Sett
ing
Heal
thc ar
epract
it
ioner
sfr
om twocl
ini
calar
easwerei
nvol
vedint
heres
earc
h,inc
ludinganEmergenc
yDepa
rtment,a
ndanIntens
iveCareUni
t.Comingfrom ar
angeofseni
ori
ti
esandprof
es-
si
ons,over120healt
hprac
tit
ione
rsc
onsent
edtoha
vingthe
irha
ndove
rprac
tic
efil
me d,t
obeinvol
vedint
hefa
cil
ita
tedre
fle
xivesess
ions
,andt
opa r
ti
cipa
teinimple
menti
ngtherede
signe
dha n-
dove
rpr oce
sse
s.

Resul t
s
He a
lthcarepract
it
ione
rswe r
ee nabl
edtoi dent
ifyorgani
sat
ional
,e nvir
onme nta
l,andpr of
ess
ionali
ssuestha
timpa ct
edont hei
rhandoverpract
ice.Fol
lowingr e
fle
xiveviewingoforigi
nalhandover
foot
age,handoverproces
seswe rere
de s
ignedto:facil
it
atee
a r
lyinsightintoprevi
ouslyunrecogni
sedcli
nica
lorope ra
tiona
lproblems;enhanc
ec oordi
nati
ona ndeffi
ciencyofcar
e,ande nha
nce
juni
or-se
niorcommunicati
ona ndteachi
ng.Me thodologi
cal
ly,t
hes tudye vi
ncesthat‘bott
om-up’handoverr
edesignproducesoutc
ome stha
tharbourlocalfi
t,pract
it
ionerowner
ship,andgeneral
poli
cyr e
levanceintha
ttheysoughttore a
lis
ec ont
inuit
yofpa t
ientcare,effe
cti
ves uper
visi
on,andcross-
dis
cipl
inarycommuni ca
tion,a
lbei
tont hestr
engthofdiffe
renthandove
rde si
gns.

Conclusi
ons
Bywor ki
ngwithhea
lthcar
epra
cti
tioner
sinawa yt
hatr e
spect
stheirabi
li
tytone got
iat
elocalcl
inicals
ervic
ecomplexit
ya nddevi
sefunct
ionalhandoversolut
ions,t
hisvideo-base
ds t
udydemon-
st
rat
esthatr
efl
exi
veme t
hodsar
eane ffe
cti
vewayofe ngagi
ngfrontl
inest
affi
nt heredesi
gnofha ndovercommunic
ation.Heal
thcarepra
ctit
ioner
ss hows t
ronginter
estinthisapproa
chbecaus
e
t
heyknowt hecompl
exit
yofthei
rlocalcli
nic
als
ett
inginti
matel
y,theyunders
tandwha tisposs
ibletochangeandhow,a ndthe
yga i
ndirec
tc ont
roloverthewa ytheyredesignthei
rhandove
rprac
-
t
ices
.

Ref
erences

[1]Iede
maR,LongD,For s
ythR,Le
eB.Visibi
li
zingCl
ini
calWork:Video
Ethnographyi
ntheCont
empora
ryHospi
tal
.Healt
hSociol
ogyReview.2006;15:156
68.

[2]I
edemaR,For syt
hR,Georgi
ouJ,Bra
ithwai
teJ,West
brookJ.Vide
or e
sea
rchin
heal
th:Vis
ibil
izi
ngtheef
fec
tsofcomput
eriz
ingcl
ini
calcar
e.Quali
tat
iveHeal
th
Resear
ch.2007;6:1530.

[3]Carr
ollK,Iede
maR,Ke rr
idgeR.Resha
pingICUWardRoundPr a
cti
cesUs
ing
Video-
Re f
lexi
veEthnogr
aphy
.Quali
tat
iveHeal
thRes
ear
ch.2008;18:387.

*I edema,R.Me rric
k,E.Ra jbha
ndari
,D.Ga rdo,A.,Sti
rl
ing,A.
,& He r
kes
,R.
(c
onditi
onall
ya cc
e pted).Vi
ewingthetaken-
for-
grantedfr
om underadif
fer
enta
s pe
ct:
avideo-ba
sedme thodi npurs
uitofpat
ientsaf
ety.I
nternat
iona
lJourna
lforMult
iple
ResearchMethods.

Pr
ofessorRickIe
dema( Pri
ncipalI
nve
sti
gat
or)
Pr
ofessorofOrgani
sat
ionalCommunicat
ion
Dir
e c
toroftheCent
reforHe alt
hCommunicat
ion
Univers
ityofTec
hnology,Sydney
Austr
alia

r
ick.
iede
ma@ut
s.
edu.
au

www.
communi
cat
ionsaf
ety
.or
g
Thi
spr
oje
cti
sfunde
dbyt
heAus
tra
lia
nCommi
ssi
onf
orSa
fet
yandQua
lit
yinHe
alt
hCa
re.