Improving weekend handover in a teaching hospital elective general surgery department

Frontiers in Surgery

Surgery

Terence Lo¹  Tehmina Nadeem¹  Eloise Dexter¹  Ayla Brown¹  Josephine Walshaw²  Marina Yiasemidou³ 

[1] Department of General Surgery, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom;Department of General Surgery, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom;Department of Health Sciences, Faculty of Sciences, University of York, York, United Kingdom;Department of General Surgery, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom;

关键词: quality improvement;    handover;    patient safety;    teamwork;    general surgery;   

DOI  :  10.3389/fsurg.2023.1263502

 received in 2023-07-19, accepted in 2023-09-11,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundEffective documentation and transfer of clinical information are vital for the continuity of care, patient safety, and maintaining medico-legal records, as outlined by the Royal College of Surgeons “Safe Handover: Guidance from the Working Time Directive working party”. Our elective surgery weekend team cross-covers both Colorectal and Upper Gastrointestinal surgical specialties across multiple wards, which poses a significant challenge. The aim of this study was to improve the documentation of patients' weekend plans through the introduction of a weekend handover proforma.MethodWe reviewed the weekend plans of 199 patients overall. 41 records were initially reviewed over a 2-week period. The surgical multidisciplinary team was then surveyed to establish the need for an improved weekend handover. Following this, a weekend handover proforma was introduced as part of the Friday ward round and education on the expectations were provided at a local Surgery Clinical Governance meeting. The documentation of the weekend plan was reviewed for 158 patients over a 6-week period and a post-intervention survey was disseminated.ResultsThe preliminary survey highlighted concerns for delayed discharges and patient safety over the weekend, with 88.2% of respondents agreeing a weekend handover proforma would be beneficial. The initial data confirmed inadequate documentation of diagnosis (19.5%), operation/procedure (28.1%), and weekend plans for blood tests (19.5%), discharge planning (2.4%), diet (46.3%), antibiotics (19.5%), intravenous (IV) fluids (22.0%), mobility (19.5%) and drain/wound care (37.5%). After education and implementing a weekend handover proforma, these results increased for documentation of diagnosis (61.2%), operation/procedure (83.2%), blood tests (59.7%), and discharge planning (85.8%). However, there was little improvement in diet (53.0%) and no improvement in the weekend plans for antibiotics (14.2%), IV fluids (17.2%), mobility (14.9%) and drain/wound care (20.2%). The post-intervention survey showed an improvement across all areas, notably continuity of care and patient safety, with 95.5% of individuals finding the weekend handover proforma aided in patient care over the weekend.ConclusionEducation of the ward team and implementation of a weekend handover proforma resulted in a marked improvement in the documentation of patients' weekend plans, which is essential to ensure the continuation of safe and effective patient care.

【 授权许可】

Unknown   
© 2023 Dexter, Walshaw, Brown, Nadeem, Yiasemidou and Lo.

【 图 表 】

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