Dataset Information

Improving handover of acute orthopaedic admissions.

ABSTRACT: Handover is a crucial part of patient care and is a well recognized cause of patient harm if not performed well. The introduction of full shift working for doctors has placed even more emphasis on this area of patient care. We identified handover of orthopaedic admissions in our unit was substandard. A prospective audit over a one week period including the weekend was undertaken. The Royal College of Surgeons of England guidance on handovers was used as minimum criteria and we also included criteria essential for handover of orthopaedic patients. This initial audit revealed a poor standard of handover. 21 patients were included and in particular patient location (57%), responsible consultant (14%), and pending investigations (29%) were poorly performed. In addition two patient safety incidents were noted, including one admission that was not handed over. To improve the handover we created a trauma specific handover proforma. We then conducted a re-audit again over a one week period including the weekend with the proforma in use. There was a notable improvement, 17 patients were included and only 3 criteria fell below 80%. We presented our findings at the local audit meeting where the results were discussed with all members of the trauma team. We suggested that an electronic proforma, accessible from multiple computers within the hospital may improve handover further. This was created in conjunction with the IT department. Once again we reaudited handover over a one week period including the weekend with the electronic proforma in use. 23 patients were included and a further improvement was noted; only one criterion fell below 95%. In conclusion handover of acute fracture admissions within the unit has undoubtedly improved. The electronic proforma tool was a simple, cost effective, and accurate method of improving handover.

SUBMITTER: Karayiannis P

PROVIDER: S-EPMC4693070 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Improving handover of acute orthopaedic admissions.

Karayiannis Paul P Warnock Jonathan J

BMJ quality improvement reports 20151023 1

Handover is a crucial part of patient care and is a well recognized cause of patient harm if not performed well. The introduction of full shift working for doctors has placed even more emphasis on this area of patient care. We identified handover of orthopaedic admissions in our unit was substandard. A prospective audit over a one week period including the weekend was undertaken. The Royal College of Surgeons of England guidance on handovers was used as minimum criteria and we also included crit ...[more]

PMID: 26734416

Similar Datasets

Project description:Clinical Handover remains one of the most perilous procedures in medicine (1). Weekend handover has emerged as a key area of concern with high variability in handover processes across hospitals (1,2,4, 5-10). Studying weekend handover processes within medicine at an acute teaching hospital revealed huge variability in documented content and structure. A total of 12 different pro formas were in use by the medical day-team to handover to the weekend team on-call. A Likert-survey of doctors revealed 93% felt the current handover system needed improvement with 71% stating that it did not ensure patient safety (Chi-squared, p-value <0.001, n=32). Semi-structured interviews of doctors identified common themes including "a lack of consistency in approach" "poor standardization" and "high variability". Seeking to address concerns of standardization, a standardized handover pro forma was developed using Royal College of Physician (RCP) guidelines (2), with direct end-user input. Results following implementation revealed a considerable improvement in documented ceiling of care, urgency of task and team member assignment with 100% uptake of the new proforma at both 4-week and 6-month post-implementation analyses. 88% of doctors surveyed perceived that the new proforma improved patient safety (p<0.01, n=25), with 62% highlighting that it allowed doctors to work more efficiently. Results also revealed that 44% felt further improvements were needed and highlighted electronic solutions and handover training as main priorities. Handover briefing was subsequently incorporated into junior doctor induction and education modules delivered, with good feedback. Following collaboration with key stakeholders and with end-user input, integrated electronic handover software was designed and funding secured. The software is currently under final development. Introducing a standardized handover proforma can be an effective initial step in improving weekend handover. Handover education and end-user involvement are key in improving the process. Electronic handover solutions have been shown to significantly increase the quality of handover and are worth considering (9, 10).

Dataset Information

Improving handover of acute orthopaedic admissions.

Publications

Improving handover of acute orthopaedic admissions.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets