Revision to crew changeovers

The crew changeover process has recently been revised to take into account learning from incidents reported on Datix.

Any changeover decisions now need to be confirmed with a clinical coordinator in EOC, or a similarly experienced clinician, if a paramedic isn’t on scene with the patient. This change has been brought in as an extra safety net, for both you and the patient.

It’s important to remember that if you’re a paramedic and you choose to agree with the changeover, you are clinically responsible for that decision and that patient, and you are accountable for the outcome.

Crew changeovers help to minimise late finishes and reduces the impact these have on you.

As a reminder, the key principles of the process are that:

• the changeover must be clinically safe and not detrimental to the patient’s care and outcome; the patient must be stable, not likely to deteriorate with a crew changeover, and result in no adverse delay to the patient being transported to the appropriate care facility
• if a paramedic is present, you must be in agreement with the changeover and you are responsible for the decision and patient outcome; if no paramedic is present, the decision to enact a changeover crew must be confirmed with a clinical coordinator or similarly experienced clinician in EOC
• the proposed changeover must be explained to the patient and their relatives, and you should get verbal consent for the changeover from the patient; if the patient or appropriate individual doesn’t give consent then the changeover shouldn’t take place.
• patient care must be maintained, with the appropriate skill level to meet the needs of the patient. For example, a stable minor fracture that needs ongoing morphine must be handed over to an appropriately skilled crew.

You can read the full EOC instruction, which goes into the changeover process and procedure in more detail, here on East24.

If you have any issues whilst on scene or afterwards, please escalate to the duty EOC officer or a duty locality officer as appropriate.

Published 25th May, 2017