Standardization of Oncology Resident Handover Notes in Order to Improve Patient Safety

Abstract

Communication errors are a leading cause of adverse events in healthcare. Resident handover notes are not standardized. This resident led quality improvement project aimed to produce a standardized patient handover note with goal of 100% compliance at 12 months. We implemented a standardized handover note using Advancing Safety for Patients in Residency Education (ASPIRE) sessions. In the first session the residents reviewed sample weekend and holiday handover notes with the ASPIRE attending. This was followed by take home project where the residents reviewed data elements that are crucial to a safe handover note. In the following ASPIRE session the residents used consensus based recommendations regarding data elements that were deemed essential in a handover document. The standardized handover document was distributed to all staff and off service residents. The intervention was evaluated by reviewing compliance over the first 10 months. Compliance with the standardized handover note was 75% in the first three months of implementation. Compliance was 100% in the most recent three months. The average compliance is 90% in the first 10 months. Patient code status was addressed on average 48% of the time. Patient location was stated on average 79% of the time. Using ASPIRE sessions we were able to produce a standardized handover note. Our aim was to reduce communication errors and improve patient safety. Compliance increased in the first 10 months. Code status and patient location can be further optimized. This project can be adapted at other programs to improve patient safety.