PGY3 at CDHB
A Closed Loop Audit Looking at the Standard of Morning Handovers in General Medicine at Christchurch Hospital
Handover is the transfer of professional responsibility and accountability for a patient between healthcare workers. Inappropriate or incomplete handover may be a contributor to error and patient harm.
To assess the standards of handovers at the daily general medical morning meeting
We performed a closed loop audit on the information used to identify patients during the handover. We looked at how many identifiers were used for each patient (including full name, national health index (NHI) number and age). The data was collected prospectively, analysed, and presented at a morning meeting. We then implemented an intervention in an attempt to improve standards and collected more data to complete the audit cycle.
A total of 208 patient handovers were included. Prior to the intervention, 88% of patients were handed over with their full name stated, 8% were handed over with an NHI, 7% had two identifiers and 5% had three identifiers. Post implementation of enforcing guidelines, 90% were handed over with full name stated, 82% were handed over with an NHI, 71% had two identifiers and 63% had three identifiers.
Effective communication is required as handover can be a perilous time for patients; ineffective communication is a well recognized contributor to patient harm in all hospitals. The gold standard for handing over a patient is using at least three identifiers which is neither difficult nor time consuming. These results have shown that more emphasis needs to be put on handover standards in general medicine and perhaps other departments.