Structured approach in improving weekend handovers in a medical high dependency unit

Area of Science:

• Medical Care Quality
• Patient Safety
• Hospital Management

Background:

• Weekend hospital admissions are linked to increased patient morbidity and mortality.
• Contributing factors include reduced senior clinician availability and communication errors during patient handovers.
• Effective handover is crucial, especially before weekends, to mitigate risks.

Purpose of the Study:

• To assess the impact of a structured handover tool on weekend patient mortality.
• To evaluate the effectiveness of patient handover processes.
• To examine changes in documentation of resuscitation status and escalation plans.

Main Methods:

• A structured handover tool was implemented on Friday afternoons in a UK teaching hospital's medical high dependency unit.
• Data on weekend patient mortality and handover documentation were collected before (March 2013) and after (May 2013) implementation.
• The unit operates with registrar-led weekend cover.

Main Results:

• Weekend mortality decreased from 43% to 22% (odds ratio 0.37, p=0.07).
• Documentation of resuscitation status and escalation plans improved from 75% to 93%.
• Registrars reported positive feedback on the structured handover tool.

Conclusions:

• A structured, written handover process can significantly improve patient safety during weekends.
• The implemented tool enhanced communication and critical care plan documentation.
• This approach holds promise for wider adoption to reduce adverse weekend outcomes.