Clinical handovers by paramedics in the emergency department: a focused ethnographic study in an urban hospital in Northeastern Ontario
Bibliographic record
Abstract
Clinical handover is a high-risk communicative process that involves the exchange of \nclear and concise patient-focused information between healthcare providers during the transfer of \nprofessional responsibility and accountability for patient care. When a patient is transported to \nhospital by Emergency Medical Services the trajectory of their care in the emergency department \nis influenced by the clinical handover given by a paramedic to a registered nurse. A focused \nethnographic study was conducted to explore the process of Emergency Medical Service clinical \nhandover within the emergency department of a small urban hospital in Northeastern Ontario \nfrom the perspective of the paramedic. The findings revealed paramedic handover was \ninfluenced by the communication context including attitude of attention and assurance, both \nreflected in the professional dynamic between the paramedic and ED staff; the ambience of the \nED reflected in the physical layout and activity level of the ED; and the patient acuity reflected \nin the assigned Canadian Triage Acuity Scale level and frequency of individual visits to the ED. \nThe study provides evidence that paramedics strive to deliver concise, accurate \ncommunication of a clinical handover so that ED patients receive safe, competent care and that \nthere is opportunity to improve on the organizational and cultural practices of clinical handover \nin the ED.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.007 | 0.003 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".