A tool to assess the components of a safe and quality medical handover

Abstract

Background: Robust medical handovers are paramount to ensure patient safety throughout the course of a hospital admission. Anecdotal evidence within our Australian tertiary hospital suggested that medical handovers were typically less structured when compared to allied health handovers. Medical handovers at our hospital had never been evaluated before, and the development of a questionnaire to assess the key components of a safe and quality handover was necessary. This tool would evaluate our medical handovers, and identify potential areas for improvement in both the tool, and medical handover practice. Methods: Based upon a literature search, and local and national guidelines of best practice, the tool was created around six key components of quality medical handovers—members involved in handover, environment and logistics, structure and content, management plans, patient-related and documentation. The tool was developed to audit the after-hours team handover at our 600-bed tertiary hospital. The tool was trialled at 20 medical handovers for our after-hours team, results were captured on REDCap, and data analyzed. Results: The tool was useful in assessing a wide range of key medical handover components and highlighting areas for improvement within our medical handovers. Through this trial, limitations were discovered in the tool that can be incorporated into future revisions of the tool. Conclusion: Overall, this study provided valuable insight into medical handovers by identifying current clinical practice and highlighting areas for improvement. The broader utility of this tool is the ability of other health services to evaluate their own medical handover, or serve as a starting point to develop their own audit tool.