Improving paediatric clinical teaching unit handover: A quality improvement project.

Area of Science:

• Medical Education
• Patient Safety
• Quality Improvement

Background:

• Effective physician communication during patient handover is critical for safe care.
• Poor handover quality is linked to preventable adverse events in up to 75% of patients.
• Handover-related adverse events were frequently identified in Paediatric Clinical Teaching Unit (CTU) Morbidity and Mortality rounds.

Purpose of the Study:

• To reduce handover-related adverse events.
• To improve participant satisfaction with the handover process.
• To address key contributors to poor handover identified through root cause analysis.

Main Methods:

• A two-phase quality improvement project was conducted at an academic tertiary care pediatric hospital.
• Phase I involved recording adverse events and root cause analysis with residents.
• Phase II implemented targeted strategies and reassessed handover quality and resident perceptions.

Main Results:

• Interventions led to a significant decrease in interruptions and background noise during handover.
• A trend toward reduced adverse events was observed (13 in Phase I vs. 7 in Phase II).
• All residents perceived an improvement in handover quality, with over 83% reporting some to good improvement.

Conclusions:

• Simple, targeted strategies can effectively improve resident handover processes.
• Enhanced communication and reduced interruptions contribute to better patient safety during care transitions.
• The project demonstrated a positive impact on both objective measures and subjective satisfaction with handover.