Related Experiment Video
Updated: May 16, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Reduced emergency calls and improved weekend discharge after introduction of a new electronic handover system
Boloor S Rao1, Gail O Lowe, Andrew J Hughes
1General Medicine, Flinders Medical Centre, Adelaide, SA, Australia.
Objectives:
To measure the frequency and content of electronic handover before and after implementation of the Blue BARRWUE handover system, and to measure its effect on patient safety and hospital efficiency over weekends.
Design, Setting And Participants:
Point-prevalence study comparing outcomes for general medical inpatients present over weekends before implementation (1 May 2008 to 30 April 2009) and after implementation (1 May 2009 to 30 April 2010) of the Blue BARRWUE handover system at Geelong Hospital.
Intervention:
Implementation of the Blue BARRWUE handover system and its components (updated working diagnosis, background, alerts, resuscitation status, requests, who to do what and when, updates and executable discharge plan).
Main Outcome Measures:
Presence of any written handover notes or updated working diagnoses in the BOSSnet clinical information system, content of handover notes, frequency of weekend discharges and medical emergency team (MET) calls before and after implementation.
Results:
In the 12 months before implementation of the Blue BARRWUE handover system, 976 patients (47.98%) had a handover note in BOSSnet, versus 1646 patients (95.09%) in the 12 months after implementation (P< 0.001; rate ratio [RR], 20.75; 95% CI, 16.33-26.44). Before implementation, 289 patients (14.21%) were discharged over weekends, versus 353 patients (20.39%) after implementation, (P < 0.001; RR, 1.44; 95% CI, 1.25-1.65). MET calls were made for 152 general medical patients before implementation (7.47%), versus 95 general medical patients (5.49%) after implementation (P = 0.01; RR, 0.73; 95% CI, 0.57-0.94).
Conclusions:
The Blue BARRWUE system has sustainably improved written handover in our organisation and was associated with improvement in both patient safety and hospital efficiency.
Related Concept Videos
Types of Reports I: Hand-off Report
Following are the key components and categories of hand-off reports:
Purpose and Process:
SBAR I: Understanding the Concept
Standardized methods of communication have been developed to ensure that information is...
Discharge Summary Forms
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
Types of Reports III: Telephone and Verbal Reports
Here's an overview of each type:
Telephone Orders
Methods of Documentation VII: EMR
Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...