Transitions in care - transitions between practitioners

Overview

Care transitions between individual practitioners (e.g. handover between treating teams, change of specialist, change of general practitioner) carry recognised risk of information loss and discontinuity - structured handover processes and comprehensive documentation reduce this risk compared with informal, ad hoc information transfer
A frequent occurrence across the healthcare journey, particularly for patients with chronic or complex conditions who may see multiple practitioners over time, with each transition representing a potential point of information loss or care discontinuity

Information held informally by an individual practitioner (nuanced understanding of a patient's specific circumstances, unwritten context, evolving management rationale) is at risk of being lost entirely at a practitioner transition unless deliberately and explicitly documented and communicated - this explains why structured handover/transfer processes (rather than assuming the new practitioner will simply "figure it out" from the written record alone) are important for preserving continuity of care

Comprehensive, structured transfer documentation (not just a brief summary) capturing the clinical history, current management plan and its rationale, and any specific ongoing considerations supports the receiving practitioner in providing genuinely continuous care
Direct communication between outgoing and incoming practitioners (where feasible), not just written documentation alone, can capture nuanced context that written records may not fully convey

Structured handover documentation and, where feasible, direct communication between transitioning practitioners as standard practice for any significant practitioner transition
Patient and carer involvement in confirming and clarifying the transferred information helps identify and correct any gaps or miscommunication in the transition process

Information loss risk at practitioner transitions (a recognised patient safety concern), structured handover/transfer documentation practices, direct practitioner-to-practitioner communication value beyond written records alone, patient/carer role in confirming transferred information

Nuanced clinical context and unwritten management rationale held informally by a treating practitioner is genuinely at risk of being lost at a practitioner transition unless deliberately captured in structured documentation or direct communication - assuming the incoming practitioner will adequately reconstruct this context from a brief written summary alone is a recognised source of care discontinuity

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