CHHS18/070
                 Canberra Health Services
                 Procedure
                 Clinical Handover
                  Contents
                 Contents......................................................................................................................................1
                 Purpose.......................................................................................................................................2
                 Scope...........................................................................................................................................2
                 Section 1 – All Clinical Handovers...............................................................................................2
                 Section 2 – Verbal Handovers using ISBAR.................................................................................4
                 Section 3 – Written Handover and Documentation....................................................................5
                 Implementation..........................................................................................................................6
                 Related Policies, Procedures, Guidelines and Legislation...........................................................6
                 References...................................................................................................................................7
                 Definition of Terms......................................................................................................................7
                 Search Terms...............................................................................................................................8
                 Attachments................................................................................................................................8
                   Attachment 1: Situations for Clinical Handover......................................................................9
                   Attachment 2: Examples of CHS handover formats to General Practitioners and Community
                   Services.................................................................................................................................10
                   Attachment 3: ISBAR for Verbal Handover...........................................................................11
                   Attachment 4: Example of ward handover sheet in ISBAR format.......................................12
                   Attachment 5: ISBAR for Telephone Handover.....................................................................13
                   Attachment 6: ISBAR example for receiving or providing clinical investigation results via the
                   phone....................................................................................................................................14
                   Attachment 7: Example components of written documentation using ISOAP from the 
                   Community Care Program.....................................................................................................15
                 Doc Number       Version    Issued            Review Date     Area Responsible    Page
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                     Do not refer to a paper based copy of this policy document. The most current version can be found on the CHS Policy Register
                                                                                                         CHHS18/070
                  Purpose
                 The purpose of this procedure is to have a standardised clinical handover process in place to 
                 facilitate timely, relevant and structured transfer of information regarding a consumer’s care 
                 between health care clinicians to enhance the continuity of care and optimise consumer 
                 safety.
                 This will facilitate:
                 1.   Consistency in clinical handover with essential information;
                 2.   Consumer safety; and
                 3.   Maintenance of and compliance with current best practice standards. 
                                                                                            Back to Table of Contents
                  Scope
                 This procedure applies to all Canberra Health Services (CHS) staff and students involved in 
                 and responsible for consumer care and the transfer of accountability for a consumer’s care 
                 from one person to another, this includes both direct and indirect care. 
                                                                                            Back to Table of Contents
                  Section 1 – All Clinical Handovers
                 Clinical Handover refers to the transfer of professional responsibility and accountability for 
                 some or all aspects of care for a consumer, or group of consumers, to another person or 
                 professional group on a temporary or permanent basis (1). See attachment 1 for a guideline 
                 of situations for clinical handover.
                 At each point of handover during the consumer journey:
                     Use the consumer record to cross-check information, using the three unique identifiers 
                      as per Patient Identification and Procedure Matching Policy and Procedure.
                     Communicate all important findings or changes of condition/care, including reference to 
                      medication, infection status and relevant precautions, all clinical risks including falls and 
                      pressure injury and risk of deterioration and estimated date of discharge. 
                     Ensure clinician receiving handover understands and accepts the handover.
                     Ensure, where relevant a multidisciplinary approach is taken.
                     Ensure, where possible, that consumers and carers are included in handover discussions.
                     Ensure accountability and responsibility for consumer care is assigned and understood.
                     Document in the clinical record when handover of care has occurred. 
                 (1) Australian Commission on Safety and Quality in Health Care Standards 6 Clinical handover Safety and Quality
                 Improvement Guide October 2012, Page 5. 
                 All clinical areas/divisions 
                 Must have in place mechanisms to detail their local processes for handover that adhere to 
                 this procedure (such Clinical Handover in MHJHADS Procedure). These include: 
                 Doc Number       Version    Issued            Review Date     Area Responsible    Page
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                     Do not refer to a paper based copy of this policy document. The most current version can be found on the CHS Policy Register
                                                                                                        CHHS18/070
                    Mechanisms to include consumers and carers in clinical handover processes related to 
                     their care, for example, incorporate bedside handover.
                    Handover tools and procedures are relevant to the type of handover occurring.
                    Documented processes for handover are in place and include, but are not limited to:
                     o Ensuring all relevant staff are present, organised, educated and prepared for 
                          handover.
                     o Ensuring process are in place for transfer of responsibility (for example, to another 
                          health care team or shift to shift handover).
                     o Instances during the consumer journey where handover occurs (for example, ward 
                          clinical staff to Medical Imaging clinical staff).
                    Established internal processes and resources to utilise the ISBAR (Introduction, Situation,
                     Background, Assessment, Recommendation/Read back) or ISOAP (Identification, 
                     Subjective information, Objective information, Analysis/ Action/ Advice, Plan) tool (see 
                     section 2 and 3), for example:  
                     o Referral forms which incorporate the ISOAP tool as headings.
                     o Tools to support telephone handovers.
                     o Ward lists which incorporate ISBAR (See Attachment 1).
                     o Prompt sheets for staff use during verbal handover.
                     o Electronic templates for written handover or discharge which incorporate ISOAP.
                    Documented organisational procedures for escalation of critical incidents involving 
                     clinical handover.
                Clinical handovers can vary depending on consumer circumstance; points of handover 
                include but are not limited to:
                    during a shift change
                    when consumers are transferred within a health facility and/or between health facilities
                    during admission, referral or discharge (2)
                    in a ward round setting or multidisciplinary meeting where patient care and 
                     accountability is transferred e.g. medical staff to physiotherapist.
                Methods of handover can include:
                    face-to-face
                    telephone or telehealth
                    clinical documentation
                    written orders including discharge summaries
                    Outpatient letters (e.g. by Medical Officers, Allied Health, Nurse Practitioners, etc.)
                    electronic handover tools including e-Referrals. 
                (2) Australian Commission on Safety and Quality in Health Care Standards 6 Clinical handover Safety and Quality
                Improvement Guide October 2012, Page 14.
                Doc Number        Version   Issued            Review Date     Area Responsible    Page
                CHHS18/070        1         27/02/2018        01/03/2022      QSII                3 of 16
                     Do not refer to a paper based copy of this policy document. The most current version can be found on the CHS Policy Register
                                                                                                        CHHS18/070
                The following examples, including CHS handover formats to General Practitioners and 
                community based services, have been included as attachments: 
                            Attachment 2: Examples of CHS handover formats to General Practitioners and 
                     Community Services
                            Attachment 3: ISBAR for Verbal Handover
                            Attachment 4: Example of ward handover sheet in ISBAR format
                            Attachment 5: ISBAR for Telephone Handover
                            Attachment 6: ISBAR example for receiving or providing clinical investigation 
                     results via the phone
                            Attachment 7: Example components of written documentation using ISOAP from 
                     the Community Care Program
                Clinical Handover in the inpatient hospital setting 
                Clinical Handovers in hospital settings will occur at the consumer’s bedside where possible. 
                For nursing and midwifery teams this should be at least once every 24 hours. Opportunity 
                should be provided at each handover for consumers/carers to be involved. The involvement 
                of carers or visitors in handover can only occur following consent from the consumer. 
                Whilst it is preferable that handover occur at the consumer’s bedside, handover may take 
                place elsewhere, such as:
                    in a common staff only area.
                Alert: Staff must be aware of maintaining consumer privacy in common areas and multi bed 
                rooms and should seek agreement from the consumer to proceed with the handover of their
                information.  
                Handover in the ambulatory or community setting 
                All clinical handovers in the community setting either written, verbal or via e-referral are 
                required to comply with the Patient Identification and Procedure Matching Policy and 
                Procedure and the principles of handover using ISBAR or ISOAP.
                                                                                          Back to Table of Contents 
                    Section 2 – Verbal Handovers using ISBAR
                Verbal Handovers
                All verbal handovers will use the ISBAR (introduction, situation, background, assessment, 
                recommendation/read back) method of handover. This ensures that handover includes the 
                following information at a minimum in the handover process. 
                Note: ISBAR refers to the minimum amount of information that must be contained in every
                clinical handover. Clinical areas may choose to utilise ISOBAR instead where the ‘O’ 
                stands for Observation.
                Doc Number        Version   Issued            Review Date     Area Responsible    Page
                CHHS18/070        1         27/02/2018        01/03/2022      QSII                4 of 16
                     Do not refer to a paper based copy of this policy document. The most current version can be found on the CHS Policy Register