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Development of a proforma to improve quality of handover of surgical patients at the weekend
Author(s) -
Mughal Zahir,
AlJazieh Iyad,
Zaidi Hammad
Publication year - 2019
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.13063
Subject(s) - medicine , handover , clinical governance , medical record , emergency medicine , medical emergency , health care , computer network , computer science , economics , economic growth
Rationale, aims, and objectives The introduction of shift pattern of working in the medical profession has led to an increase in reliance on effective handover of patient information. We evaluated the use of a weekend handover proforma in General Surgical patients at a University Teaching Hospital. Methods A standardized weekend handover proforma was implemented. A pre‐post survey of medical staff and prospective observational study on the use of the proforma was carried out. The impact of three strategies to reinforce change in clinical practice was investigated at random time‐points. These were (1) presentation at a clinical governance meeting; (2) email; and (3) induction training on handover combined with one‐to‐one interactive training. The two outcome measures were compliance with the proforma, and “handover score,” which was the amount of data transferred per patient. Results The survey highlighted inadequate provision for handover at the weekend. National guidelines were used to design the weekend handover proforma. There was 70% compliance with the new standardized proforma with a median handover score of 83% (IQR = 0‐100). The results were presented at a clinical governance meeting, and the proforma was refined. After this change, the proforma was used in 71% of patients, and the median score was 65% (IQR = 0‐80, P = 0.0516). Compliance after an email reminder was 69%, and median handover score was 80% (IQR = 0‐90, P = 0.1037). After induction training, there was a significant improvement in proforma compliance (94%) and median score (90%, IQR = 80‐90, P = 0.013). Conclusion Effective transfer of handover information can be achieved over the weekend with the use of a standardized proforma. Use of the proforma was greatest after providing junior doctors with didactic training on handover combined with interactive guidance on completing the proforma.