Dr. Luis Teodoro da Luz | Bridging the Communication Gap in Trauma Care, one Handover at a Time

Dr. Luis Teodoro da Luz at Sunnybrook Health Sciences Centre in Canada conducted research to both identify handover communication gaps, and investigate potential solutions in the form of the IMIST-AMBO tool.

In a 2020 study, Dr. da Luz and his colleagues investigated communication gaps by observing patient handovers at a Canadian trauma center, finding that handovers had long durations, lacked structure and consistency, involved repetition, and frequently excluded important patient information, such as airway and breathing condition, and vital signs.

In a follow-up 2023 study, the researchers tested the IMIST-AMBO tool, which involved making and analyzing video recordings of paramedic handovers. Their findings showed that by adopting the IMIST-AMBO tool, trauma teams were able to experience handovers with clearer structures, minimizing both interruptions and parallel conversations among team members.

Before implementing the IMIST-AMBO tool, these handovers often faced communication issues, with paramedics encountering frequent interruptions and informal information requests after their official handover was completed. IMIST-AMBO helped to reduce these incidents and encouraged a more disciplined information exchange. As a result, each handover became more concise – cutting down the average duration by nearly a minute – and equipped trauma teams with critical patient details more efficiently.

Dr. da Luz’s approach also revealed that paramedics quickly adapted to this tool, moving from needing reminders to initiate the structured handover to adopting it naturally. This shift indicated that IMIST-AMBO not only streamlined communication but also fostered a shared mental model among team members, improving team cohesion and performance. Importantly, the tool’s mnemonic format – identifying essential details with each letter – provided a clear and repeatable structure for paramedics to follow.

The feedback from trauma teams was overwhelmingly positive, as they expressed satisfaction with both the structure and duration of the handovers. Dr. da Luz’s research illustrates the IMIST-AMBO tool’s potential to become a universal handover standard at trauma centers across the world.