Weekend handover: Improving patient safety during weekend services. (August 2020)

• Record Type: Journal Article
• Authors: Nagrecha, Rajvi; Rait, Jaideep Singh; McNairn, Kim
• Is Part Of: Annals of medicine and surgery. Volume 56(2020)
• Page Start: 77
• Page End: 81
• Publication Date: 2020-08
• Subjects: Weekend handover -- Patient safety -- Stress; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2020.06.005
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Clinical Handover has been identified as one of the most high-risk processes within medicine. Inadequate handover is a significant cause of avoidable adverse events across many hospitals. A likert-survey of the weekend handover system at a district general hospital demonstrated significant dissatisfaction amongst junior doctors. Intending to improve patient safety and reduce stress for on-call junior doctors, a weekend handover proforma was compiled according to the Royal College of Physicians and Surgeons guidelines. The proforma was trialed on six medical wards for six months with a before and after questionnaire being sent to doctors on the wards involved to determine the proforma's merits on a scale of 1 (least effective) to 10 (most effective). Reports subsequent to implementation demonstrated a 67% increase ease of identifying outstanding weekend jobs. 57% of doctors reported better understanding of their patient's diagnosis and management plan and 53% stated it was easier to identify the patients that required regular medical review over the weekend. Results also highlighted a 55% reported an increase in safety of weekend handovers (p<0.01). A closed loop audit of handover practice through the use of a standardised proforma showed improved quality, detail and consistency of handovers. The reduction in stress for junior doctors managing unknown patients with a clear concise plan, directed by a senior from the parent team during the week, has improved patient safety and doctor satisfaction. Highlights: Weekend handovers are a valuable tool to increase patient safety. Weekend handovers can reduce stress levels in junior doctors. Weekend handovers have been shown to reduce the financial and operational burden.