Principles
- Transfer of responsibility and accountability for patient care
- Part of NSQHS Standard 6, Communicating for Safety
- Structured, face to face where possible, and documented
- Poor handover contributes to adverse events and delays in care
- Occurs between shifts and teams and at transfer between wards or hospitals
- Use a quiet setting with protected time and include the senior on call
- Hand over the sickest patients first
ISBAR
| Letter | Content |
|---|---|
| I | Identify yourself and the patient |
| S | Situation, the current problem |
| B | Background, history and relevant findings |
| A | Assessment, your interpretation and observations |
| R | Recommendation, what is needed and by when |
Orthopaedic Handover
- Patients at risk of compartment syndrome, sepsis or neurovascular compromise
- Pending imaging, bloods and cultures
- Theatre plans, fasting status and anticoagulation
- Escalation plan for deterioration
- Neurovascular status and compartment checks with their timing
- Antibiotic timing for open fractures
- Patients awaiting theatre with fasting and consent status
- Patients with new or worsening pain out of proportion to the injury
Written Handover
- Electronic handover tools should match the verbal handover
- Discharge summaries hand over care to the GP
- List diagnosis, operation, medications, VTE plan, wound care, weight bearing status and follow up
- Include outstanding results and who is responsible for them
- Read back actions to close the loop
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.