Surgical handover in a tertiary hospital: a working model
Frank Piscioneri A D and Guan C. Chong B CA The Canberra Hospital, Yamba Drive, Garran, ACT 2605, Australia.
B Australian National University Medical School, Canberra, ACT, Australia.
C The Surgical Network, ACT Health, The Canberra Hospital, Yamba Drive, Garran, ACT 2605, Australia. Email: guan.chong@act.gov.au
D Corresponding author. Email: frank.piscioneri@act.gov.au
Australian Health Review 35(1) 14-17 https://doi.org/10.1071/AH09859
Submitted: 26 November 2009 Accepted: 8 July 2010 Published: 25 February 2011
Abstract
The trend, in the last few years, of shorter working hours for junior doctors has been driven by the need for safer working conditions. This has led to the loss of continuity of care and the introduction of shift work for residents and registrars, resulting in up to three handovers per 24-h period. Many sentinel events occurring in hospitals can be attributed to a breakdown in communication. Clinical handover is important because it not only facilitates continuity in the transfer of patient information between healthcare professionals but also helps identify potential problems that may occur in upcoming shifts. Methods of handover include verbal-only reports, verbal reports with note-taking and the use of printed handouts containing relevant patient information. This paper presents an exposition of a working model for morning surgical handovers in a tertiary teaching hospital that uses a printed handover sheet, is consultant-led and conference-based, and with an educational focus. A survey of resident staff confirmed the morning handover as important in both patient care and education. There was a marked improvement in tertiary trauma survey completion rates after the introduction of the morning handover. It is now an accepted and important part of the working day in the surgical unit of the hospital.
Additional keywords: morning rounds, patient safety.
References
[1] National Code of Practice: Hours of work, Shiftwork and Rostering for Hospital Doctors. Australian Medical Association; 2005. Available at http://ama.com.au/system/files/node/3756/National_Code_of_Practice_January_2005.pdf [verified 2 February 2011].[2] Standards for Safe Working Hours and Conditions for Fellows, Surgical Trainees and International Medical Graduates. Royal Australasian College of Surgeons; 2007. Available at http://www.surgeons.org/media/17658/SafeHours_small_final_printout.pdf [verified 2 February 2011].
[3] Rosenstein AH, O’Daniel M. A survey of the impact of disruptive behaviors and communication defects on patient safety. Jt Comm J Qual Patient Saf 2008; 34 464–71.
| 18714748PubMed |
[4] Barden CB, Specht MC, McCarter MD, Daly JM, Fahey TJ. Effects of limited work hours on surgical training. J Am Coll Surg 2002; 195 531–8.
| Effects of limited work hours on surgical training.Crossref | GoogleScholarGoogle Scholar | 12375759PubMed |
[5] Sanfey H, Stiles B, Hedrick T, Sawyer RG. Morning report: combining education with patient handover. Surgeon 2008; 6 94–100.
| Morning report: combining education with patient handover.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1czis1ersA%3D%3D&md5=18195cf11e477e820d8b3ebf67967bcdCAS | 18488775PubMed |
[6] McFetridge B, Gillespie M, Goode D, Melby V. An exploration of the handover process of critically ill patients between nursing staff from the emergency department and the intensive care unit. Nurs Crit Care 2007; 12 261–9.
| An exploration of the handover process of critically ill patients between nursing staff from the emergency department and the intensive care unit.Crossref | GoogleScholarGoogle Scholar | 17983360PubMed |
[7] Christie P, Robinson H. Using a communication framework at handover to boost patient outcomes. Nurs Times 2009; 105 13–5.
| 20063616PubMed |
[8] Jenkin A, Abelson-Mitchell N, Cooper S. Patient handover: time for a change? Accid Emerg Nurs 2007; 15 141–7.
| Patient handover: time for a change?Crossref | GoogleScholarGoogle Scholar | 17618118PubMed |
[9] Bomba DT, Prakash R. A description of handover processes in an Australian public hospital. Aust Health Rev 2005; 29 68–79.
| A description of handover processes in an Australian public hospital.Crossref | GoogleScholarGoogle Scholar | 15683358PubMed |
[10] Cheah LP, Amott DH, Pollard J, Watters DA. Electronic medical handover: towards safer medical care. Med J Aust 2005; 183 369–72.
| 16201956PubMed |
[11] McCann L, McHardy K, Child S. Passing the buck: clinical handovers at a tertiary hospital. N Z Med J 2007; 120 U2778
| 17972985PubMed |
[12] Fassett MJ, Hannan TJ, Roberston IK, Bollipo SJ, Fassett RG. A national survey of medical morning handover report in Australian hospitals. Med J Aust 2007; 187 164–5.
| 17680742PubMed |
[13] Alem L, Joseph M, Kethers S, Steele C, Wilkinson R. Information environments for supporting consistent registrar medical handover. HIM J 2008; 37 4–8.
| 18245860PubMed |
[14] Bhabra G, Mackeith S, Monteiro P, Pothier DD. An experimental comparison of handover methods. Ann R Coll Surg Engl 2007; 89 298–300.
| An experimental comparison of handover methods.Crossref | GoogleScholarGoogle Scholar | 17394718PubMed |
[15] Ferran NA, Metcalfe AJ, O’Doherty D. Standardised proformas improve patient handover: Audit of trauma handover practice. Patient Safety in Surgery 2008; 2 24
| Standardised proformas improve patient handover: Audit of trauma handover practice.Crossref | GoogleScholarGoogle Scholar | 18817559PubMed |
[16] Garling, P. Final Report of the Special Commission of Inquiry into Acute Care Services in NSW Public Hospitals. 2008. Available at http://lawlink.nsw.gov.au/Lawlink/Corporate/ll_corporate.nsf/pages/attorney_generals_department_acsinquiry [verified 2 February 2011].
[17] Bowden FJ, Lueck C, Hurwitz M, Kennedy K. Medical handover. Med J Aust 2006; 184 477–8. [Letter].
| 16646756PubMed |