From “Passing Information” to “Safe Handover”: Our ISBAR Journey
How the Medical-Surgical Unit at Kampala Hospital transformed clinical handover through teamwork, hands-on support, and continuous improvement.
Clinical handover is more than simply giving a report. It is a critical patient-safety process through which responsibility, clinical information, risks, and ongoing care are transferred from one healthcare professional to another.
Our journey began with a simple question:

Are we consistently communicating the right information, to the right person, at the right time?

Our baseline assessment revealed a significant gap in structured clinical handover. Out of 39 handovers observed, only 6 (15%) met the desired standard.

This was not just a number. It was an opportunity to improve.

Introducing ISBAR

We introduced ISBAR — Identify, Situation, Background, Assessment and Recommendation — as a standardized framework for clinical handover in the Medical-Surgical Unit.
However, we quickly realized that introducing a tool was only the beginning.

We Did Not Just Train — We Joined the Journey

Rather than leaving staff to implement ISBAR on their own, we attended actual handovers, participated in hands-on coaching, demonstrated how to use the tool, supported staff during real handovers, and provided immediate feedback.
We worked alongside the teams to understand the practical challenges they faced.
The approach was simple:
Teach → Demonstrate → Practice → Support → Observe → Give Feedback → Improve.
This hands-on approach helped bridge the gap between knowing ISBAR and actually using it confidently in practice.

Change Was Not Immediate

The journey came with challenges.
Some staff initially perceived ISBAR as difficult or time-consuming. Late preparation of handover reports reduced the time available for effective communication, while rushed documentation sometimes resulted in incomplete or poorly structured information.
Instead of simply pointing out the gaps, we worked with staff to understand them and find practical solutions.

The Progress

Through continued training, hands-on support, regular attendance at handovers, audits, feedback, supervision, and accountability, we began to see encouraging improvement in the adoption of structured handover practices.
Our goal is not simply to achieve a good audit score.
Our goal is to make safe, structured clinical communication part of everyday practice.

What This Journey Has Taught Us

Quality improvement is not about introducing a tool and expecting people to change overnight.
It is about being present, working alongside the team, listening, supporting, measuring, learning, and improving together.
We learned that sometimes the most effective intervention is not another policy or another training session — it is standing beside the staff and doing it with them.
Every handover is an opportunity to protect a patient.
Every communication gap is an opportunity to improve.
And every improvement begins with a team willing to learn and change.

From 15% baseline → hands-on support → continuous improvement → towards standardized, safer clinical handover.

#QualityImprovement #PatientSafety #ISBAR #ClinicalHandover #HealthcareQuality #ContinuousImprovement #Teamwork #PatientCentredCare