“Safe handover saves lives”: results from clinical audit

Author:

Advani Rajeev,Stobbs Nicola Marie,Killick Neil,Kumar B Nirmal

Abstract

Purpose – The implementation of the European Working Time Directive and its subsequent impact on the hours worked by doctors in training has resulted in shift-working rotas being the norm and greater cross-cover between specialties. As such, the need for continuity of information and comprehensiveness of handover between shifts has become more important than ever. The purpose of this paper is to show how handover can be improved by the implementation of an electronic handover system and subsequent Quality Improvement Rapid Cycle Change Model of clinical audit. Design/methodology/approach – Initial data were collected using a standardised questionnaire collected prospectively from all junior doctors within the surgical division. Following the first audit cycle, changes were implemented in a Quality Improvement Rapid Cycle Change Model of clinical audit and a Surgical Division Electronic Handover Shared Drive was developed. Three further prospective cycles of clinical audit were carried out over a period of 12 months. Findings – The results show a more effective handover system to be in place. Effects of change measured as an 80 per cent standard was achieved in all categories and maintained throughout all cycles of re-audit. Practical implications – A surgical division shared electronic handover drive was developed and subsequent audits have shown improved handover practice in a foundation trust. This has positive benefits on patient safety and quality of care. Originality/value – This work is of interest to those looking to set up an electronic handover system and additionally to all those working in specialities where cross-cover is required.

Publisher

Emerald

Subject

Health Policy

Reference9 articles.

1. Bhabra, G. , Mackeith, S. , Monteiro, P. and Pothier, D.D. (2007), “An experimental comparison of handover methods”, Annals of the Royal College of Surgeons of England , Vol. 89 No. 3, pp. 298-300.

2. British Medical Association (BMA), Junior Doctors Committee, National Patient Safety Agency, NHS Modernisation Agency, National Patient Safety Agency (2004), Safe Handover: Safe Patients. Guidance on Clinical Handover for Clinicians and Managers , BMA, London.

3. Department of Health (2005), An Organisation with a Memory. Report of an Expert Group on Learning from Adverse Events in the NHS , Department of Health, London.

4. Ferran, N.A. , Metcalfe, A.J. and O’Doherty, D. (2008), “Standardised proformas improve patient handover: audit of trauma handover practice”, Patient Safety in Surgery , Vol. 2 No 2, available at: www.biomedcentral.com/about/faq/citation (accessed 25 September 2009).

5. General Medical Council (2013), “Good Medical Practice”, available at: www.gmc-uk.org/ guidance/ good_medical_practice.asp (accessed 3 March 2013).

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