Audit of handover in an ENT unit

Effective written handover is essential for maintaining continuity of care in surgical departments. Prior research has shown that incomplete or absent handovers can lead to communication gaps and patient safety risks. In ENT units, where patient care often involves multiple shifts and cross-coverage, accurate documentation is particularly important. However, no prior work had resolved the specific impact of audit interventions on handover quality in this specialty. This gap motivated the current study to assess the baseline state of written handovers in an ENT unit and evaluate the effect of targeted interventions. The study aimed to align with Royal College of Surgeons of England guidance, which emphasizes the importance of standardized handover practices. Establishing a baseline for handover completeness was a key step in identifying areas for improvement. The absence of clear data on handover practices in ENT units highlighted the need for a focused audit. This paper contributes by providing a detailed analysis of handover quality before and after intervention. The findings may help inform similar quality improvement efforts in other surgical departments.

The study aimed to evaluate the completeness and accuracy of written handovers in an ENT department and implement strategies to improve standards. The primary objective was to assess whether audit interventions could enhance handover practices in line with professional guidelines. The specific problem addressed was the lack of consistent and complete handover documentation, which could compromise patient care. The motivation for the study stemmed from the Royal College of Surgeons of England guidance, which highlights the importance of structured handovers. The study sought to measure the baseline quality of handovers and track changes after implementing targeted interventions. Emphasizing the role of junior doctors and cross-covering teams was a key focus of the study. The goal was to ensure that all team members, regardless of specialty, understood the importance of accurate handovers. This approach aimed to improve both the quantity and quality of written handovers over time.

The study employed a prospective audit design to evaluate written handovers in an ENT department. Data collection occurred over two distinct periods, each lasting 30 and 18 days respectively. The first period established a baseline by measuring the presence and completeness of morning and evening handovers. The second period assessed changes after implementing interventions such as reminders and feedback sessions. The audit focused on two key times: morning and evening handovers, which are critical for shift transitions. The Royal College of Surgeons of England guidance was used as a benchmark for evaluating handover quality. Junior doctors and cross-covering teams were included in the audit to assess their adherence to handover standards. Regular feedback sessions were conducted to reinforce the importance of accurate documentation. The study did not use any advanced tools or technologies, relying instead on observational data and manual audits.

The audit revealed significant variability in handover completeness during the first period. Morning handovers were present and complete on 77% of days, while 6% were incomplete or illegible, and 17% were absent. Evening handovers were present and complete on only 30% of days, with 67% being absent. These findings indicated a need for improvement, particularly in the evening shift. After implementing interventions such as reminders and feedback, the second audit period showed notable improvements. The proportion of complete morning handovers increased, and evening handovers also saw a marked improvement in completeness. The interventions emphasized the importance of accurate handovers to both the ENT team and junior doctors. The study demonstrated that targeted feedback and reminders could effectively enhance handover practices. The most significant change was observed in the evening handover, which improved from 30% complete to a higher proportion in the second period. These results suggest that structured interventions can lead to measurable improvements in handover quality.

The study demonstrated that audit interventions can lead to measurable improvements in the completeness and accuracy of written handovers in an ENT unit. The authors propose that emphasizing the importance of handovers and providing regular feedback can enhance adherence to professional guidelines. The findings suggest that targeted interventions are effective in addressing gaps in handover practices. The study supports the Royal College of Surgeons of England guidance by showing that structured handovers can be improved through focused efforts. The authors highlight that junior doctors and cross-covering teams play a crucial role in maintaining handover standards. The observed improvements in the second audit period indicate that interventions can be successfully implemented in clinical settings. The study does not claim that these interventions are essential for all departments but suggests that they may be beneficial in similar contexts. The authors conclude that ongoing audits and feedback mechanisms are necessary to sustain improvements in handover practices.