The sustainability of Medical Morning Handover Reporting: adherence in a regional hospital

Abstract

Background.The Medical Morning Handover Report is a form of clinical handover and is considered to be an essential mechanism for continuity of care and adverse event minimisation within a hospital environment. It is considered a significant Quality of Care activity recommended in Australian Medical Association clinical handover guidelines. The sustainability of such activities has not been reported. Aim.We aimed to assess the sustainability of Medical Morning Handover Reporting (MMHR) in the Department of Medicine at the Launceston General Hospital since its implementation in 2001. Methods.We conducted a quality improvement survey amongst the medical staff (pre-graduate and post graduate medical faculties) to assess its sustainability since implementation in 2001. Results.There were 30 respondents of whom 19 attended MMHR daily, four attended weekly, and only five attended less than weekly. Attendance rates at MMHR were maintained from 2001 to 2009 based on comparisons with previously conducted surveys. Conclusions.This study shows MMHR is sustainable and has evolved in format to incorporate advances in Health Information Technology. We believe adherence is dependent on providing leadership and structure to MMHR. What is known about the topic?Since the mid 2000s, the MMHR has emerged as a significant quality intervention activity in our Department of Medicine, with particular emphasis on the first 12–24 h of a patient's encounter with the hospital with conditions that are considered to be medical diagnoses. When considered relevant follow up feedback on previous admissions is covered by the meeting. What does this paper add?This paper attempts to add measurable end points for the quality of the MMHR meeting, the importance of measuring sustainability and introduce the concepts relating to the use of health information technologies as significant decision support and peer review tools within the meeting. What are the implications for practitioners?This study has several implications for clinicians in hospitals: (1) the Report is an essential component of ongoing quality of care handover to maintain the continuity of care and to apply the necessary variations in care uncovered during the handover process. (2) Strict adherence to the meeting time frame improves the MMHR efficiency. (3) Consultant staff attendance has a strong positive influence on the care and educational benefits of the meeting. (4) The integrated use of e-technologies appears to have a strong positive effect on decision making and education during MMHR.