Surgical handover in a tertiary hospital: a working model

The trend, in the last few years, of shorter working hours for junior doctors has been driven by the need for safer working conditions. This has led to the loss of continuity of care and the introduction of shift work for residents and registrars, resulting in up to three handovers per 24-h period. Many sentinel events occurring in hospitals can be attributed to a breakdown in communication. Clinical handover is important because it not only facilitates continuity in the transfer of patient information between healthcare professionals but also helps identify potential problems that may occur in upcoming shifts. Methods of handover include verbal-only reports, verbal reports with note-taking and the use of printed handouts containing relevant patient information. This paper presents an exposition of a working model for morning surgical handovers in a tertiary teaching hospital that uses a printed handover sheet, is consultant-led and conference-based, and with an educational focus. A survey of resident staff confirmed the morning handover as important in both patient care and education. There was a marked improvement in tertiary trauma survey completion rates after the introduction of the morning handover. It is now an accepted and important part of the working day in the surgical unit of the hospital.