Photo: MSF
Deliverables
Challenges
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MSF is a large organisation, which comes with large organisational challenges. Handover is one example of institutional knowledge being lost at a key moment in the field. The potential for improvement is great, solving some of the issues associated with handover could mean that other instances of knowledge being lost could be addressed. For instance, if clear information on where and how files should be stored and shared was communicated during handover, this would have a positive effect on the way knowledge is stored and shared at MSF more widely.
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Living organogram template, tested with field staff Flexible handover template, tested with field staff National staff buddy guide, tested in theory (verbal feedback rather than live tested) with field staff Report on findings Best practice guide
Outcome measurement Recent data from the newly developed nursing debriefing tool currently scores handover quality at 2 out of 5 on average. This score will now act as an indicator of change, although it cannot reflect any meaningful results inside of the 6-month timeline of this project. The nursing debriefing tool asks 'How well did you handover period with your predecessor prepare you for your mission?'. This question gives insight into whether handover is working. We also suggest the question: 'Did you feel prepared for your role upon entering the project?'. As this covers the quality of onboarding in general. Qualitative evidence is also a key way of measuring handover, to identify whether or people were prepared on entering the field. If not, why? If so, how can this be replicated across missions? These are the questions we asked during this process and we advocate that these questions continue to be asked during debriefings.
32 | Redesigning Hospital Handover
Due to the field being a busy environment, testing at MSF is a challenge. The support of an advisory group was key to accessing field staff to understand their handover barriers and get their feedback on the prototyped solutions. However, without the support of a Head of Mission, it was not possible to fully test the solutions in a project. The next step in improving handover is to try the flexible template, living organogram and national staff buddy system live in a project. Only then can the new handover process be adapted then scaled across MSF’s projects.