Identifying What’s Vital in Shift Handover: The ABC-VITAL Model for ED Transitions

Shift handover in EDs is a critical event that directly impacts patient safety, care continuity, and staff well-being. This technical report introduces the ABC-VITAL model of shift handover, structured around three essential components: Assistance, Balance, and Closure. The model was developed from the convergence of healthcare management, emergency medicine, and academic leadership and is designed to be adaptable across different levels of complexity and clinical profiles. The Assistance component is based on the ID-VITAL framework, which supports structured, decision-oriented clinical communication. The Balance component addresses the emotional and interpersonal aspects of handover, promoting team cohesion and a psychologically safe work environment. The Closure component promotes operational anticipation and team synchronization to guide the incoming team's operational planning. This model reframes the shift handover as a clinical, human, and strategic process, with the potential to influence organizational culture in emergency care settings.