Impact of a structured template and staff training on compliance and quality of clinical handover

Change in junior doctors working pattern has brought effective and safe clinical handover into a central role to ensure the patient safety and high quality care. We investigated whether the compliance and quality of clinical handover could be improved through the use of a standardised and structured handover template.

A computerised template was developed in accordance with handover guidelines provided by the Royal College of Surgeons of England. Pre- and post-intervention audits against an eleven-point dataset pertaining to the handover of acute surgical admissions were undertaken. The results from the two discrete audits periods were compared to examine the impact of intervention.

There were 137 acute surgical admissions during pre-intervention and 155 admissions in post-intervention audit period. A significant improvement in overall handover practice was observed in post-intervention period. The documentation of patient hospital number (84 (61%) vs. 132 (85%) p<0.001), past medical history (39 (28%) vs. 75 (48%) p<0.001) and patient assessment by a senior member of the on-call team (3 (2%) vs. 125 (85%) p<0.001) all demonstrated significant improvements upon use of structured template. Compliance to effective handover improved following increased awareness of the importance of safe clinical handover among the junior doctors.

Implementation of a standardised guideline-based structured handover template and training of junior doctors are likely to improve compliance to agreed standards, promote quality of care, and protect patient safety.