Improving measurement in clinical handover.

BACKGROUND Poor clinical handover creates discontinuities in care leading to patient harm. However, the field of handover research continues to lack standardised definitions and reliable measurement tools to identify factors that would lead to harm reduction and improved safety strategies. OBJECTIVE This paper introduces a conceptual framework to underpin a research agenda around the important patient safety topic of clinical handover. METHODS Five frameworks with potential application to clinical handover were identified in a consultation process with clinicians, researchers and policy makers. RESULTS The framework consists of three key handover elements-information, responsibility and/or accountability and system-in relation to three key measurement elements-policy, practice and evaluation. Using this framework an analysis of current "gaps" in the measurement of handover was completed. CONCLUSION The paper argues that measurement will identify gaps in knowledge about handover practice and promote rigor in the design and evaluation of interventions to reduce patient harm.