Improving medical handover at the weekend: a quality improvement project

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Management

Background:

• Medical handover is critical for patient safety, especially with evolving doctor shift patterns.
• Broomfield Hospital faced challenges with a dual electronic and paper system for weekend medical handover.
• Existing processes led to inefficiencies and potential risks, necessitating an improved system.

Purpose of the Study:

• To implement a new electronic system for weekend medical handover at Broomfield Hospital.
• To enhance the organization of weekend handover meetings to promote patient safety.
• To address identified insufficiencies in the previous weekend handover process.

Main Methods:

• Surveys were conducted with doctors to identify issues with the existing dual electronic and paper handover system.
• A new, user-friendly electronic handover database and structured meeting process were introduced.
• Post-implementation surveys and informal interviews assessed the impact of the changes on handover quality and safety.

Main Results:

• Pre-implementation: Only 12% used the electronic system; 89% found job sorting time-consuming; 67% received incorrect grade jobs; 41% knew discharge recipients. Subjective safety: 3.18/5.
• Post-implementation: 100% used the electronic system; 47% found job sorting time-consuming; 89% knew discharge recipients. Subjective safety improved to 3.84/5.
• High satisfaction reported through informal ward interviews, indicating improved workflow and clarity.

Conclusions:

• A structured, organized weekend handover meeting combined with an effective electronic system significantly enhances medical handover quality.
• The new system improved efficiency, clarity, and awareness regarding patient care responsibilities during weekends.
• The implemented changes align with Royal College of Physicians' medical handover guidelines, promoting better patient safety.