Clinical Handover: Quality Assessment of the Multidisciplinary Handover Process On an Acute Psychiatric Mixed Gender General Adult Inpatient Ward

Abstract

Handover allows the transfer of responsibility for patient care between healthcare professionals. In 2011, The Royal College of Physicians (RCOP) outlined a set of standards for a ‘good handover’. Poor quality handover leads to error and is a preventable cause of patient harm. The aim of this audit was to analyse the handover process on a 26-bedded general adult inpatient ward, and make recommendations from the findings to improve patient-safety based upon these standards. During 14 handovers, quantitative information was collected on duration, attendees and content of information, graded against the RCOPs standards. In 100% of handovers, 1 nurse and 2 doctors were present. Members from other professional bodies attended less often (14-79%). Information duplicated on consecutive days ranged between 27% and 42%. The handover process met 50% of the RCOP’s standards. Handover process is embedded in the hospital culture and is recognised as a multidisciplinary activity. However, inconsistent attendance did not provide equal opportunity for the transfer of information or result in clear arrangements for ongoing care, which was felt to be a risk to patient safety. A system of fluid and transferable data on documentation should be in place. It was agreed that a computerised handover-sheet available to all professionals to review and access during the course of the day would be in place. A suitable time to maximise attendance was agreed. Re-audit following these recommendations would form a robust framework to implement these changes across the Unit.