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Research objective 2

To determine how variations in handover processes lead to “near misses” and adverse outcomes

Near misses of care and other sub-threshold events that may ultimately impair the quality of care delivered at the bedside will be examined. The primary aim is to perform research that should result in structural improvements in handover processes of complex patients across various care settings. We will analyze focus group and interview data to identify barriers and facilitators to effective communication. Using these data, we will construct a cause and effect model using the Ishikawa method, specifically exploring the roles of the place, procedures, people, and policies as barriers or facilitators to effective communication. We will also conduct a process analysis of the maps with a focus on improvement with the aim of identifying inefficiencies, removing obvious redundancies or complexities, and facilitating and aligning goals.