Clinical and Non-clinical Handovers: Designing for Critical Moments

Recent studies call for attention to the relevant work that non-clinical personnel do, not only to support clinical work, but also to the overall healthcare information infrastructure. Based on a case study of orderlies work in a major university hospital, we further investigate and characterize orderlies work with particular focus on handover situations as these support the collaboration and continuous coverage of hospital work practices. The case study involves interviews with orderlies and clinicians and a pilot study of a task management application. Based on our findings, we describe three different types of handovers (clinical to non-clinical, non-clinical to clinical, and intra non-clinical), and highlight the challenges that arise during the main tasks with handovers situations: patient transport and patient mobilization. We discuss the importance of establishing and sustaining a common ground, supporting the alignment of tasks and negotiations, as well as enhancing the patient contact within and among clinical and non-clinical personnel. We also present a couple of design recommendations to account for these challenges and handover types in the design of handover tools to support orderlies work practices.