1. F1 projects surgical handover
Matthew Boardman & Ana Borges

2. Introduction 20 to 30+ general surgical admissions per day
12 hour shifts
Handover twice a day
No formal record existed of patients admitted
ad hoc recording of patient details
hand written lists ( re-typing information  errors)
inefficiency
Risk of patients:
being ‘missed off’ the list
not having key information handed over

3. Accident Causation
Swiss cheese model of accident causation. James Reason, 2000

4. Guidance British Medical Association1 recommends: use of proformas
relevant IT support for handovers
Royal College of Surgeons2 sets out minimum data necessary for safe handover
(demographics, diagnosis, clinical info, jobs, etc.)
1.) British Medical Association: Safe Handover: Safe Patients – Guidance on Clinical Handover for Clinicians and Managers. 2004
2.) Royal College of Surgeons of England: Safe Handover: Guidance from the Working Time Directive working party. 2007

5. Aims Comprehensive electronic record of patient admissions
Accessible to the clinical team
Improve consistency and accuracy of handover
Improve patient safety

6. Method Initial audit Consultation with colleagues
Development of proforma
Communication
Implementation of proforma
Re-audit (+/- refinement)

7. The Proforma Patient demographics Problem and diagnosis Blood results
Jobs
Phone/bleep numbers and pancreatitis scoring

8. Results (Proforma implemented 1st Feb 2011)
% days where a patient list was recorded
Initial audit Aug 2010 to Jan 2011
44%
Re-audit Feb to March 2011
93%

9. Results
Quality of data recorded improved after implementing the proforma

10. Feedback On-call lists now easier to find Simple to use proforma
Allows quick transfer of information
time is saved (no re-typing of information)
risk of errors in copying data reduced
(pancreatitis scoring scale useful)

11. Conclusion
A simple intervention that promotes clear communication can achieve significant improvements in the recording and transfer of patient information between on-call hospital teams
Patient safety likely to benefit
But….human factors are still key