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Getting a Handle on Handover: Improving the E-Handover Process for Duty Doctors in Psychiatry

Published online by Cambridge University Press:  07 July 2023

Emily Ong
Affiliation:
NHS Lanarkshire, Glasgow, United Kingdom
Emma Docherty*
Affiliation:
NHS Lanarkshire, Glasgow, United Kingdom
Gillian Cuthbertson
Affiliation:
NHS Lanarkshire, Glasgow, United Kingdom
Eugene Wong
Affiliation:
NHS Lanarkshire, Glasgow, United Kingdom
*
*Corresponding author.
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Abstract

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Aims

Effective handover is a vital aspect of patient safety and continuity of care. On-call junior doctors (the Duty Doctor) in psychiatry inpatient wards in University Hospital Hairmyres (UHH) and University Hospital Wishaw (UHW) use an electronic handover tool (e-handover) to supplement handover. This lists outstanding jobs and information to be aware of. This project aimed to improve the handover process by making amendments to the e-handover.

Methods

A Plan, Do, See, Act (PDSA) cycle structured the project. An electronic survey was sent to all 30 Duty Doctors. This contained a Likert scale, 1 being negative and 10 being positive, to rate the handover process, alongside space for free text comments to be given. Thematic analysis identified common themes within these comments.

Changes were implemented in response to the survey findings. Space was added to the e-handover for each patient's care team (parent team), as well as their contact details. The Duty Doctors were informed of the changes and a post-intervention survey was sent six weeks later.

Results

There was a total of 22 responses (73.3%) to the pre-intervention survey. Themes identified from the free text comments included: Organisation of tasks; Ease of use; Reliability; Inappropriate use; Technical issues; Handover update; Task information and Ward information. The most common theme was inappropriate use of e-handover. It was identified that tasks were being added to the e-handover that would be more appropriately actioned by the parent team.

There was a total of 12 responses (40%) to the post-intervention survey. A demonstrable improvement in the rating of the handover process was found. Free text comments showed that the changes made were helpful. Common themes were identified from the comments. One theme was ‘Missing information’, which included a lack of clarity on the date a job was added to the e-handover. Future changes could include adding space to the e-handover for this information.

Conclusion

Following the adjustments made to the e-handover there was an improvement in the satisfaction amongst the Duty Doctors.

One limitation identified was the lower response rate for the post intervention survey. We postulated that this was due to the survey being distributed when junior doctors changed clinical rotations and left the Duty Doctor role. This could be considered for future improvement cycles.

Additionally, free text comments from the post intervention survey could be utilised to inform future improvements.

Type
Quality Improvement
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NC
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. This does not need to be placed under each abstract, just each page is fine.
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

Footnotes

Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard BJPsych Open peer review process and should not be quoted as peer-reviewed by BJPsych Open in any subsequent publication.

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