SIGN UP TO SAFETY TRANSFER OF CARE HANDOVER PSC POOLE HOSPITAL NHS FOUNDATION TRUST HANDOVER PROJECT TEAM

OUR COLLABORATIVE TEAM NameOrganisational roleCollaborative roleAway or Home team member* Val HornMatronHandover Project LeadAway Lara Walker Cara Southgate Sister Senior Health Care Assistant Team Member Away Jodie UphillSisterTeam MemberAway Nicola Bryan Occupational TherapistTeam MemberAway Hayley ElgarDischarge FacilitatorTeam MemberAway Sally CobbDeputy SisterTeam MemberAway Dr John-Paul Carpenter Dr Georgina Wood Consultant Junior Doctor Team Member Home Dr Rupert PageConsultantTeam MemberHome Dr Brian LockeyConsultantTeam MemberHome Lisa Brinkman Tracey Cooper IT Clinical Nurse AdvisorsTeam MemberAway

OUR COLLABORATIVE HANDOVER TEAM Team Handover – Home and Away!

THE BIG ROOM

THE BIG ROOM – PROMOTING PROJECT INTEGRATION Ward Transfer E-Handover Sheets Dr Rupert Page Medical Handover Dr Carpenter 7 day Working Handover Community Hospital Transfer E Nurse Assessments IT Clinical Nurse Advisors Denise Richards

WHAT CHANGE CAN WE MAKE THAT WILL RESULT IN AN IMPROVEMENT What solutions do we want to test? Design a Trustwide Handover of Care Proforma Redesign the current process Identify key staff Reduce the adverse incidence related to poor handover across the trust Improve patient safety and quality

OUR PROJECT Identified key area for improvement - Transfer from the Emergency Department to the Assessment Unit Transfer from the Assessment Unit to the Inpatient Wards This handover is vital in communicating Presenting problem Initial diagnosis Person specific information 1 st line intervention Immediate care needs

BASELINE DATA/ EVIDENCE OF NEED TO CHANGE On average there are 1964 patient transfers per month across the hospital 1000 AIRS incident related to Poor Transfer per year incorporates medication errors delay in initial interventions ordered poor communication OOHs transfer outside of the Trust Transfer Policy Sub-standard transfer RCA - recommendations Complaints/ Patient feedback

TEAM AIMS Issues to consider: What do we need to do to make beds available promptly? What standards do we want for transfer? How can we speed up transfer and make it safe? Who is the best person to handover and how? Can we use tools to support us?

METHODOLOGY FOR THE PROJECT TEAM -Use “ BIG ROOM” approach to redesign the process -A weekly multi-agency and multi-disciplinary service improvement meeting -Sharing staff and patient stories -Review data / PDSA Cycles -Emerging themes and principles are real-time -Team work to develop jointly owned solutions to continually improve

PREPARATION Prior to First PDSA : Define the common principles of safe transfer information Identify and agree the pilot areas for the PDSA process Design a Handover template Agree a process for the collection of baseline audit Communicate the principles of the project to participating areas Scope other Handover projects currently been undertaken in the trust, create links and include key stakeholders

WHAT DID WE FIND? No common principles applied across the trust Various transfer forms Most transfer information is scribbled on nurses handover forms All capture different information Staff transferring patients not always the staff member who has been involved in caring for the patient in the preceding clinical area

WHERE WE ARE NOW Several PDSA Cycles have been managed to support the development of the handover proforma PMO have supported the design and template development Successful team working in managing the PDSA Cycles Collaboration with the Medical IT Handover Development Group commenced Collaboration with the E-nurse Assessment Team is in place - two of the IT Clinical nurse advisors have joined the Handover Team Information and Risk departments supporting the evidence and data gathering Partnership working with the DHCT Handover group

CHALLENGES Resistance to Change Articulating the objective trustwide Need to keep a focused approach

FUTURE PLANS PMO to support a baseline audit following patients through the ED and Assessment units – Dates planned To widen the test areas for clinical engagement Develop guidance and revisit Trust Transfer policy Share progress with DHC Commence specific handover work between PHFT Trauma unit and Alderney Hospital