Handover practice amongst core surgical trainees at the Oxford School of Surgery

Hazim Sadideen,Tony Jefferis,Lucy Cogswell,Tim Goodacre,Munir Saadeddin,Karim Hamaoui

doi:10.3352/jeehp.2014.11.3

Abstract

Purpose:To date no studies have specifically evaluated the use of handovers amongst core surgical trainees (CSTs) in the United Kingdom. We examined handover practice at the Oxford School of Surgery to assess and improve CSTs’ perception of handover use as well as its quality, and ultimately patient care.Methods:Based on guidelines published by the British Medical Association and Royal College of Surgeons, a 5-point Likert style questionnaire that collected data on handover practice, its educational value, and the CSTs’satisfaction with handover was given to 50 CSTs in 2010.Results:Forty CSTs (80.0%) responded to the questionnaire. The most striking findings revolved around the perceived educational value, formal training, and auditing practice of handovers throughout various units, which were all remarkably lower than expected. As a result, handover practice amongst CSTs was targeted and revised at the University Hospital’s Department of Plastic Surgery, with the implementation of targeted changes to improve handover practice.Conclusion:The execution of daily handovers was an underused educational tool amongst surveyed CSTs and may be an important modality to target, particularly in the competency-based, time-limited training CSTs receive. We recommend modifications to current practice based on our results and the literature and encourage the assessment of handover practice at other institutions.

Highlights

The National Patient Safety Agency in the United Kingdom (UK) defines handover as “the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or groups of patients, to another person or professional group on a temporary or permanent basis” [1]
Questionnaire data was divided into the following categories: (1) handover practice and patient safety, (2) policy and training, and (3) educational value
A minimum of two handovers occurred per day, one in the morning (AM) and one in the evening (PM), and 22% of core surgical trainees (CSTs) reported a third intra-day handover

Summary

Introduction

The National Patient Safety Agency in the United Kingdom (UK) defines handover as “the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or groups of patients, to another person or professional group on a temporary or permanent basis” [1]. One of the goals in reducing working hours amongst trainees is to reduce the rates of medical and surgical errors due to potential fatigue from excessive on-call commitments [3]. To facilitate this reduction in working hours, a transition has been made from an on-call system to a shift-based rota

Methods

Results

Conclusion