Implementing an electronic clinical handover system in a university teaching hospital

Clinical handover is defined as inter-clinician communication occurring at care interfaces. In this study, we analyse the clinical outcomes and physician attitudes associated with the implementation of a electronic clinical handover system in our medical department.

The aim of this project was to introduce a reliable, standardised, reproducible method of communicating information regarding inpatients within our medical department. We also sought to assess the attitudes of physicians within our department to medical handover.

We designed and implemented an electronic handover template with a protocol to guide staff as to its use. Handover was audited weekly. In addition, we surveyed attitudes of doctors to handover before and after our handover pilot.

An average of 32 patients were handed over each week. Compliance with mandatory handover of ICU/CCU patients averaged at 59%. Extrapolating our pilot results for the year would result in approximately 1655 handover events per annum in our department. One hundred percent of physicians surveyed felt that documentation of handover was beneficial, and staff satisfaction with handover improved after initiation of the pilot (81 vs 24%, p = 0.000914). While 64% of staff were concerned that typed electronic handover would increase their workload, only 6% of the post pilot survey group felt that it did increase workload significantly.

Electronic clinical handover is feasible and practical within the Irish healthcare system. In addition, it was found in our study to be attractive and effective to physicians without increasing their workload.