Quality Of Patient Handover Research Articles

Anaesthesia residents' perception of the quality of patient handover: A multicentre, nonrandomised, high-fidelity simulation study.

Anaesthesia residents' perception of the quality of patient handover: A multicentre, nonrandomised, high-fidelity simulation study.

PATIENT HANDOVER

Patient handover is considered to be one of the most delicate medical procedures as well as the most preventable cause of medical error. It takes place at primary, secondary and tertiary healthcare, with specificities at every level of healthcare. Improvement in the quality of patient handover is therefore essential for good medical practice. Accurate and comprehensive communication between medical staff is required for patient safety and continuous adequate healthcare. In this article, we describe recommendations for successful and efficient patient handover and highlight communication errors during the process. Special attention is given to handover of rheumatological patients and transition from pediatric to adult healthcare. Also, we emphasize the necessity of education. Medical staff should be competent in sharing and exchanging relevant information when the patient transfers to another medical care provider. Teaching communication skills has been part of undergraduate and postgraduate curriculum in medical schools. At the Universitiy of Zagreb School of Medicine we have introduced a longitudinal six-year course Fundamentals of Medical Skills where special attention is given to communication skills. Nevertheless, medical specialty training still lacks educational contents specialized in patient handover and safe patient discharge.

Surgeon agreement at the time of handover, a prospective cohort study.

BackgroundAcute Care Surgical Teams are responsible for emergent surgical patients, and as such require regular handover and coordination between different surgeons. Despite the recent emergence of this model of care, minimal research has been conducted on the quality of patient handover and no research has attempted to determine the rate of clinical agreement or disagreement among surgeons participating in these teams.MethodsA prospective cohort study was carried out with our acute care surgical service at a tertiary care teaching hospital from January 2 to March 31 2012. At the conclusion of the daily morning handover, receiving surgeons were asked to indicate, on provided handover sheets, whether they agreed with the proposed management plan for each patient that was discussed. The specific aspects of care over which they disagreed were also described, and disagreements were classified a priori as major or minor. The primary outcome was the rate of disagreement over the handed over management plan.ResultsSix staff surgeons agreed to participate and a total of 417 unique patients were handed over during the study period. For the primary outcome, a total of 41 disagreements were recorded for a disagreement rate of 9.8 %. 15 of the 41 disagreements were classified as major, for a major disagreement rate of 3.6 %. Consultant to consultant disagreements were classified as major disagreements 63 % of the time, whereas consultant to resident disagreements were classified as major 31 % of the time (P = 0.217). On average, the age of patients for which a clinical disagreement occurred were older; 63 vs. 57 (P < 0.05).ConclusionsDespite the frequency of handovers in clinical practice, little research has been conducted to determine the rate of disagreement over patient management among surgeons participating working in academic centers. This study demonstrated that the rate of clinical disagreement is low among surgeons working in an tertiary care teaching hospital.

The effect of a checklist on the quality of patient handover from the operating room to the intensive care unit: A randomized controlled trial

PurposeHandover of patient care is a potential safety risk for the patient due to loss of information which may result in adverse outcome. We hypothesized that a checklist for handover from the operating room (OR) to the intensive care unit (ICU) will lead to an increase of quality regarding information transfer compared with a nonstandardized handover procedure. Materials and methodsThe study was conducted as a prospective, randomized trial in a university hospital. The quality of handovers with checklist was compared with handovers without checklist. Handovers were recorded by digital voice recorder and analyzed using an individual rating sheet for each patient. This enabled to discriminate between items that “must be handed over” (red items) and items that “should be handed over” (yellow items). ResultsA total of 121 patient handovers from OR to ICU were included. Significantly more red items were handed over in the study group compared with the control group (study group: median 87.1%, 25-27 percentile 77.1%-90.0%; control group: median 75.0%, 25-75 percentile 66.7%-88.6%; P < .01). ConclusionsThis study gives first evidence that the use of a standardized checklist for patient handover from OR to ICU increases the quantity and quality of transmitted medical information.

Quality of Patient Handover on Intensive Care Units in Northwest England

Continuity of patient care in the intensive care unit is dependent on reliable and accurate handover. The introduction of shift working for junior doctors as a result of the working time directive has resulted in a minimum of two handovers between medical staff in each 24-hour period. Structure and method of handover has been shown to critically influence the transfer of clinical information vital to the continuity of patient care. We conducted a telephone survey of the intensive care units in the north-west of England to establish details surrounding the methodology of handovers which are currently being used. We established that handovers in our region are generally occurring in a structured manner, but that the quality of handover, information transmitted and personnel present is varied. We advocate the use of a computer-based handover sheet to increase the accuracy of the handover process.