Impact of a structured template and staff training on compliance and quality of clinical handover

Abstract

Introduction: Change in junior doctors working pattern has brought effective and safe clinical handover into a central role to ensure the patient safety and high quality care. We investigated whether the compliance and quality of clinical handover could be improved through the use of a standardised and structured handover template. Methods: A computerised template was developed in accordance with handover guidelines provided by the Royal College of Surgeons of England. Pre- and post-intervention audits against an eleven-point dataset pertaining to the handover of acute surgical admissions were undertaken. The results from the two discrete audits periods were compared to examine the impact of intervention. Results: There were 137 acute surgical admissions during pre-intervention and 155 admissions in post-intervention audit period. A significant improvement in overall handover practice was observed in post-intervention period. The documentation of patient hospital number (84 (61%) vs. 132 (85%) p < 0.001), past medical history (39 (28%) vs. 75 (48%) p < 0.001) and patient assessment by a senior member of the on-call team (3 (2%) vs. 125 (85%) p < 0.001) all demonstrated significant improvements upon use of structured template. Compliance to effective handover improved following increased awareness of the importance of safe clinical handover among the junior doctors. Conclusion: Implementation of a standardised guideline-based structured handover template and training of junior doctors are likely to improve compliance to agreed standards, promote quality of care, and protect patient safety. © 2012 Surgical Associates Ltd.