Improving trainee psychiatrist's handover: standard setting and audit

Abstract

Purpose – The 2006 Post Graduate Medical Education Trust Board (PMETB) trainees' survey indicated inadequacies in handover procedures amongst medical and psychiatry trainees nationwide; and in 2007 a local psychiatry trainees' survey found inadequate handover procedures. The purpose of this paper is to show how to improve handover practice through standard setting and sequential audit. Design/methodology/approach – A Trust wide Standard Operating Procedure (SOP) for handover was developed. Trainees were audited on perception of handover experiences (2008, 2009 and 2010). Findings – The audit revealed that the SOP was not consistently followed. Handing over “active problems” (AP) was perceived to occur frequently in 2008 (93.75 per cent), improved in 2009 (100 per cent for AP, 98 per cent for “problems which may arise”, (PA)); however deteriorated in 2010 (93 per cent for AP, 69 per cent for PA). Trainee satisfaction rates with handover improved each year (57 per cent in 2008, 75 per cent in 2009, 87 per cent in 2010, X2=3.7, df=2, p=0.16). Practical implications – SOP development, subsequent audits and sharing of results improved handover practice. This has implications for training and patient safety. This project demonstrates a method of improving handover practices in a large mental health trust. Originality/value – The work conducted is of interest to those working in psychiatry, not only from an education and training perspective, but also for clinical practice, in the UK as well as internationally.