Human Centered Design of Handovers / Virtual Handovers

Patient transfers (handovers) from surgery to intensive care units (ICUs) are known to be fraught with communication and technical errors: barriers in care which multiple studies highlight a relationship between the quality of handovers and patient outcomes.

The Human Centered Design of Handovers/Virtual Handovers project aims to improve communication and decrease preventable adverse events related to OR to Neuro-ICU handovers.  The project will achieve this through the development and use of a web-based, modular, multi-modal education platform which will include instructional videos and an interactive, immersive “virtual handover game.”   As a modular platform, material can be added to address all types of handovers from shift-to-shift to more unit-specific processes.

The virtual handover game was developed using a human centered design: a methodology that incorporates feedback from users throughout the development process.  This process allows users to shape the design product and enhance its usability, as well as allowing them to be closely involved in the refinement of their own handover process.  As part of the HCD process, focus groups were conducted with key members in the neuro ICU and OR.  Feedback from the focus groups were then analyzed via conventional content analysis and integrated into the educational program.

Feedback collected through the focus groups and analyzed via conventional content analysis will be integrated into a multimodal educational program including 3DiTeams (a virtual environment for learning and practice), on-site clinical observations and technology-mediated coaching.  This educational program aims to improve handover quality and patient safety in critical care.  The final product will be a modular program that can be expanded to address all types of handovers from shift-to-shift to more unit-specific processes (in this case OR to Neuro ICU).

After the launch of the education program, an educational research study will be conducted to evaluate the role of mentorship in the retention of teamwork behaviors.

The study aims to provide pilot data for the research hypothesis that mentoring will slow the decay of learned teamwork and communication behaviors to greater extent than self-study alone or no intervention.

For further information regarding the Handover project, please contact Genevieve DeMaria at

Handover Types

3Di Handover Types

Handover Filming Photo Gallery

Handover Testimonials

Handover Resources

3Di Teams Powerpoint

Project Team:

  • Dr. Jeffrey Taekman – Principal Investigator and Director HSPSC

The HSPSC Team and Executive Committee:

  • Dr. Kathryn Andolsek
  • Dr. Atilio Barbeito
  • Al Bonifacio
  • Mr. Bob Blessing
  • Dr. Chris DeRienzo
  • Mrs. Mary Holtschneider
  • Dr. Jonathan Mark
  • Ms. Marie McCulloh
  • Dr. David McDonagh
  • Ms. Judy Milne
  • Dr. Chitra Pathiavadi
  • Dr. Christy Pirone
  • Dr. Noa Segall
  • Dr. David Turner
  • Dr. Melanie Wright

Special thanks to for their support and contributions to this project:

  • Duke University Hospital
  • Australian Commission on Safety and Quality in Health Care (2010). The OSSIE Guide to Clinical
  • Handover Improvement. Sydney, ACSQHC.
  • CS&E Handoff Team, UT Southwestern Medical Center
  • Durham Patient Safety Center of Inquiry and VA National Center for Patient Safety
  • Charles George VA Medical Center, Asheville, NC
  • Turnip Video
  • BreakAway Games
  • All of our partners who donated their time, effort, and talent to making this project possible

Funding provided by Pfizer and Abbott.

In collaboration with BreakAway, Itd.

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Phone: 919-684-3661
Fax: 919-684-6251

Duke Human Simulation and Patient Safety Center
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Suite 5010, 5th Floor, Trent Semans Center
DUMC Box 3094
Durham, NC 27710

Chris KeithHuman Centered Design of Handovers / Virtual Handovers