1. Emily Hayes FY1 Daniel Crossman FY1

2.  The importance of communication  SBAR  Escalating to seniors  Handovers between shifts and at weekends  E-handover on CRRS

3.  Good communication: ◦ Improves patient understanding ◦ Has been shown to improve patient safety and care Will make your life much easier!  By using SBAR you can gather your thoughts and communicate succinctly  Structured and effective handover is key to good continuation of patient care (BMA guidelines)

4.  Situation  Background  Assessment  Request/Recommendation

5.  Introduce yourself ◦ Full name, grade, where you are.  Patient details ◦ Name, age  Current problem ◦ Brief explanation, obs, MEWS

6.  Patient background ◦ Reason and date of admission  What has happened during admission  E.g. surgery, investigations etc.  Past medical history ◦ Important and relevant  Level of escalation for this patient ◦ DNAR, ward-based care, ITU/HDU

7.  Ensure you have taken a brief history and examined the patient  Explain what you have done so far ◦ Oxygen, VBG/ABG, urine dipstick, bloods, fluids, catheter, imaging requests  What do you think is happening? (Don’t worry if you don’t have a clue!)

8.  What do you want from this person? ◦ Advice ◦ Assessment ◦ Urgent Assessment  When are they coming?  What can you do in the meantime?

9.  “Hi, my name is Dan. I’m one of the Cardio F1s. I am calling about a 78 year old gentleman who has developed central crushing chest pain. He was admitted with worsening SOB and has a background of IHD and diabetes. His ECG shows new T wave inversion in the anterior leads but he is otherwise stable. I have started ACS treatment and given him some GTN and morphine. I would like you to review him ASAP. Is there anything else I can do in the meantime?”

10.  Within hours, your seniors will be: ◦ SHO ◦ Your registrar ◦ Consultant in charge of patient  Out of hours ◦ SHO ◦ Registrar  Use SBAR  Don’t be scared to escalate early!

11.  Some wards have their SHOs covering till 9pm ◦ Go through your list together, let them know what jobs need doing/chasing and what they should do with those results.  Unknown cover – update CRRS handover, add any jobs.  If you’re away and someone else is covering your patients, ensure your list is updated.  If on AMU1- handover period, go through CRRS and summarise each patient and jobs.

12.  Again, it may be one of your ward SHOs ◦ Update your list, go through this together on Friday  Someone new ◦ Update CRRS, print out lists with jobs  Leave a summary of the patient in the notes.

13.  Log on to CRRS  On the left side, click handover icon  Leave summaries for your patients  Add any jobs and specify: ◦ For whom ◦ Level of importance ◦ What you want them to do

14.  Don’t be afraid to ask for help  Use SBAR to organise your thoughts  Organise your lists and update CRRS regularly  No one expects you to know everything