The sustainability of Medical Morning Handover Reporting: adherence in a regional hospital
Terry J. Hannan A D , Stanley Bart A , Colin Sharp A , Mathew J. Fassett A and Robert G. Fassett B CA Department of Medicine, Launceston General Hospital, Charles Street, Launceston, TAS 7250, Australia. Email: stanley.bart@dhhs.tas.gov.au; colin.sharp@dhhs.tas.gov.au; matthew.fassett@gmail.com
B Royal Brisbane and Women’s Hospital, Renal Medicine, Level 9, Ned Hanlon Building, Herston, QLD 4029, Australia.
C Central Clinical Division, School of Medicine, University of Queensland, Australia. Email: r.fassett@uq.edu.au
D Corresponding author. Email: terry.hannan@dhhs.tas.gov.au
Australian Health Review 34(3) 325-327 https://doi.org/10.1071/AH09820
Submitted: 10 August 2009 Accepted: 26 November 2009 Published: 25 August 2010
Abstract
Background. The Medical Morning Handover Report is a form of clinical handover and is considered to be an essential mechanism for continuity of care and adverse event minimisation within a hospital environment. It is considered a significant Quality of Care activity recommended in Australian Medical Association clinical handover guidelines. The sustainability of such activities has not been reported.
Aim. We aimed to assess the sustainability of Medical Morning Handover Reporting (MMHR) in the Department of Medicine at the Launceston General Hospital since its implementation in 2001.
Methods. We conducted a quality improvement survey amongst the medical staff (pre-graduate and post graduate medical faculties) to assess its sustainability since implementation in 2001.
Results. There were 30 respondents of whom 19 attended MMHR daily, four attended weekly, and only five attended less than weekly. Attendance rates at MMHR were maintained from 2001 to 2009 based on comparisons with previously conducted surveys.
Conclusions. This study shows MMHR is sustainable and has evolved in format to incorporate advances in Health Information Technology. We believe adherence is dependent on providing leadership and structure to MMHR.
What is known about the topic? Since the mid 2000s, the MMHR has emerged as a significant quality intervention activity in our Department of Medicine, with particular emphasis on the first 12–24 h of a patient's encounter with the hospital with conditions that are considered to be medical diagnoses. When considered relevant follow up feedback on previous admissions is covered by the meeting.
What does this paper add? This paper attempts to add measurable end points for the quality of the MMHR meeting, the importance of measuring sustainability and introduce the concepts relating to the use of health information technologies as significant decision support and peer review tools within the meeting.
What are the implications for practitioners? This study has several implications for clinicians in hospitals: (1) the Report is an essential component of ongoing quality of care handover to maintain the continuity of care and to apply the necessary variations in care uncovered during the handover process. (2) Strict adherence to the meeting time frame improves the MMHR efficiency. (3) Consultant staff attendance has a strong positive influence on the care and educational benefits of the meeting. (4) The integrated use of e-technologies appears to have a strong positive effect on decision making and education during MMHR.
[1] Fassett RG, Bollipo SJ. Morning report: an Australian experience. Med J Aust 2006; 184(4): 159–61.
| PubMed | [verified 30 July 2010].
[3]
[4]
[5] Fassett MJ, Hannan TJ, Robertson IK, Bollipo SJ, Fassett RG. A national survey of medical morning handover report in Australian hospitals. Med J Aust 2007; 187(3): 164–5.
| PubMed |
[6] Loh E. A national survey of medical morning handover report in Australian hospitals. Med J Aust 2007; 187(10): 595.
| PubMed |
[7] Fassett MJ, Hannan TJ, Robertson IK, Bollipo SJ, Fassett RG.
| PubMed |
[8] Herman BA, Iyer RN, Godier KJ. Safety and efficacy of offsite percutaneous coronary interventions in 1348 consecutive patients in rural Tasmania. Am J Cardiol 2008; 102(10): 1323–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[9] Bart S, Hannan T. The use of existing low-cost technologies to enhance the medical record documentation using a summary patient record. Stud Health Technol Inform 2007; 129(Pt 1): 350–3.
| PubMed | CAS |
[10] Fries J. Alternatives in medical record formats. Med Care 1974; 12 871–81.
| Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |
[11] Whiting-O’Keefe QE, Simborg DW, Epstein WV. A controlled experiment to evaluate the use of a time-oriented summary medical record. Med Care 1980; 18 842–52.
| Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |
[12] Kripalani S, LeFevre F, Phillips C, Williams M, Basaviah P, Baker D. Deficits in communication and information transfer between hospital-based and primary care physicians implications for patient safety and continuity of care. J Am Med Assoc 2007; 297 831–41.
| Crossref | GoogleScholarGoogle Scholar | CAS |
[13] Tierney WM, Kanter AS, Fraser HSF, Bailey C. A toolkit for e-health partnerships in low-income nations. Health Aff 2010; 29(2): 268–73.
| Crossref | GoogleScholarGoogle Scholar |
[14]
[15] Alem L, Joseph M, Kethers S, Steele C, Wilkinson R. Information environments for supporting consistent registrar medical handover. HIM J 2008; 37(1): 9–25.
| PubMed |
