Objectives and Background Transitions in patient care pose a significant risk to patient safety, because they can lead to discontinuity of patient care and adverse events due to information loss during handover or unnecessary delays as a result of poor handover.
The goals of our project were to:
Create a standardised process and documentation for doctor-to-doctor handover in our Emergency Department (ED).
Improve handover as an educational experience for registrars.
Shorten the duration of handover without compromising quality of information.
Methods Setting: Urban district ED with 40 000 presentations annually. Development of best practice handover process: Handover processes were audited using video and direct observation by the Handover Improvement Team. Data collected included times, information quality and documentation. Staff and patient surveys were undertaken. Best practice was defined by literature review, multidisciplinary collaboration and consumer input. Handover process and forms were compiled into a new handover policy. Implementation: The new policy was presented at educational meetings, circulated to staff via email and advertised by poster in the ED and handover room. Re-audit: Handover audit by Handover Improvement Team was repeated. Patient handover forms were reviewed. Staff survey was undertaken. Analysis: Descriptive statistics were used to analyse data.
Results The development phase took 7 months and resulted in our “SHARE the CARE Plan”, which will be presented. Implementation occurred over 3 weeks. Post-implementation audit showed improvement in documentation, increased multidisciplinary collaboration and teaching. A staff survey showed that the majority of doctors surveyed agreed that the new process was appropriate and helpful. Other results will be presented.
Conclusions Development of a new best practice policy with a multidisciplinary team takes time. The new handover process is supported by the majority of staff and has resulted in improved documentation, collaboration and teaching.