Completed Projects

Doctors' shift handovers in acute settings

Dr Michelle Raduma-Tomas, School of Psychology
Patient handover in healthcare encompasses two main components.  First the exchange of patient information detailing the patient's current condition, ongoing treatment and developments or complications.  Second the transfer of responsibility and accountability for a patient from one caregiver to another.  Handovers are considered a high risk process where communication failures can cause problems in the continuity of patient care and potentially contribute to the occurrence of an adverse event.  The aim of this research project was to examine how doctors' conducted shift handovers in acute medical admissions units using observations and interviews.

This PhD project was funded by the Scottish Funding Council 2008-2011.


Raduma Tomas, M., Flin, R., Yule, S. & Close, S. (2012). The importance of preparation for doctors' handovers in an acute medical assessment unit: a hierarchical task analysis. BMJ Quality and Safety, 21, 211–217.

Raduma Tomas, M. (2012) Doctors' shift handovers in acute medical units. PhD thesis. University of Aberdeen.

Raduma Tomas, M., Flin, R., Yule, S. & Williams, D. (2011). Doctors' handovers in hospitals: A literature review. BMJ Quality & Safety, 20, 128-133.

Safe Handover - Handover practices assuring patient safety at care transitions from anaesthesia

Dr Tanja Manser, Prof Rhona Flin, School of Psychology

The definition of patient handover is 'the transfer of professional responsibility and accountability for some or all aspects of care for a patient or group of patients to another person or professional group on a temporary or permanent basis'.  Recent research suggests that patient handover is a critical aspect of care and yet a lack of training and formal requirements for patient handover can impede good practice.  Consequently the main aim of this research project was to identify handover strategies that help clinicians to assure continuity of care and maintain safety of surgical patients during care transitions between anaesthesia and the recovery room or the intensive care unit (ICU). Ultimately, the results of this study will contribute to the advancement of patient safety by providing important input on effective patient handover guidelines and training modules that can be integrated into the education of undergraduate and practising health professionals.

This research project was funded by the European Commission (FP7 Marie Curie Intra-European Fellowship) 2009-2010.


Manser, T., Foster, S., Flin, R. & Patey, R. (2013). Team communication during patient handover from the operating room: more than facts and figures. Human Factors, 55, 138-156.;0018720812451594v1

Manser, T. & Foster, S. (2011). Effective handover communication: an overview of research and improvement methods. Best Practice and Research Clinical Anaesthesiology, 25, 181–191.

Team leadership in the intensive care unit (ICU)

Dr Tom Reader, Prof Rhona Flin, School of Psychology

Teamwork refers to the way in which team members function and coordinate to produce 'synchronised' output. Patient safety research has demonstrated that poor teamwork is a causal factor underlying critical incidents in the intensive care unit (ICU). Due to this, a growing amount of research has been conducted within the ICU in order to identify the specific components of teamwork that influence patient outcomes.  Consequently, the main aim of this research project was to investigate aspects of teamwork and team leadership in the intensive care unit. The primary focus was on the leadership behaviours used by consultants to manage complex multidisciplinary teams during normal and crisis operations. 

This project was funded by the Scottish Funding Council 2006–2007 and a Leverhulme Early Career Fellowship 2008-2010.


Reader, T., Flin, R. & Cuthbertson, B. (2011) Team situation awareness and the anticipation of patient progress during ICU rounds. BMJ Quality and Safety, 20, 1035–1042.

Reader, T., Flin, R. & Cuthbertson, B. (2011). Team leadership in the Intensive Care Unit. Critical Care Medicine, 39, 1683-1691.

Reader, T., Flin, R., Mearns, K. & Cuthbertson, B. (2009). Developing a team performance framework for the intensive care unit. Critical Care Medicine, 37, 1787–1793.

Team skills training for nuclear operations personnel

Prof Rhona Flin and Dr Paul O'Connor, School of Psychology


Effective teamworking in high-risk industries is crucial for safety and productivity.  The aim of this project was to study the team skills required for high levels of performance by nuclear plant control room personnel.  The research consisted of observation and interviews.  The results were used to develop a nuclear team skills taxonomy.  The taxonomy had five categories of teamwork behaviour: situation awareness, decision-making, communication, co-ordination and influence.  

This investigation was commissioned by the UK Nuclear Industry Management Committee.


O'Connor, P., O'Dea, A., Flin, R. & Belton, S. (2008). Identifying the team skills required by nuclear power plant operations personnel. International Journal of Industrial Ergonomics, 38, 1028–1037.