Improving hospital weekend handover: a user-centered, standardised approach.

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Management

Background:

• Clinical handover, particularly during weekends, presents significant risks due to process variability.
• Existing handover systems in acute teaching hospitals show substantial inconsistencies in content and structure.
• Physician surveys indicate a strong consensus (93%) on the need for handover improvement, with 71% doubting current systems ensure patient safety.

Purpose of the Study:

• To address the variability and lack of standardization in weekend medical handover.
• To develop and implement a standardized handover pro forma based on Royal College of Physician guidelines and end-user input.
• To evaluate the impact of the standardized pro forma on handover quality, patient safety, and efficiency.

Main Methods:

• Development of a standardized handover pro forma incorporating Royal College of Physician guidelines and physician feedback.
• Implementation of the new pro forma in an acute teaching hospital's medical department.
• Post-implementation analysis using surveys and tracking pro forma uptake at 4 weeks and 6 months.

Main Results:

• 100% uptake of the new standardized pro forma by 4 and 6 months post-implementation.
• Significant improvements in documented ceiling of care, task urgency, and team member assignment.
• 88% of physicians perceived improved patient safety, and 62% reported increased efficiency.

Conclusions:

• A standardized handover pro forma is an effective initial step to improve weekend medical handover.
• Handover education and end-user involvement are critical for process enhancement.
• Electronic handover solutions show promise for further quality improvement in clinical handovers.