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- W4312238126 abstract "Background: International research has highlighted a number of problems in handovers. 1 Despite being identified as a key part of a patient’s journey, no standardised best practice exists.2 In our anaesthetic department, anecdotal reports of suboptimal handover practice, poor trainee survey results, and accreditation requirements all naturally led to targeted improvement. We aimed to: (1) introduce a standardised anaesthetic shift handover process compliant with Royal College of Anaesthetists (RCoA) Anaesthesia Clinical Services Accreditation (ACSA) standard 1.1.1.3 (‘there is a structured handover between shifts’)3 with a target of >75% of handovers being dated and persons identifiable; (2) undertake semi-structured interviews to test the hypothesis that the intervention: (a) led to improved stakeholder perception of handover, (b) improved perception of patient safety, and (c) better information exchange. Our objective was to improve questionnaire scores by 10%. Methods: Handover quality was assessed through observations and semi-structured interviews. This guided development of a new handover aide memoire/documentation which was introduced in December 2021. The project was audited at 7 weeks looking at the primary aims including engagement with the new process and repeating the semi-structured interviews to assess stakeholder perception. Results: Documentation occurred in 86.7% of handovers, with 82.6% dated, and 81.6% dated with an identifiable clinician (signed, noted as being present, or both). Semi-structured interviews of 10 anaesthetic staff showed the intervention improved handover (Fig. 1). In the scoring system where 5 was top marks for handover, there was an average improvement in scoring of 1.44 (pre- and post-intervention mean scores of 2.8 and 4.2, respectively, a 28.8% increase). Similarly, it was felt patient safety was improved – scores increased by 1.2 (3 and 4.2; 24%). There was a smaller increase (from 3.5 to 4.2, 14%) in whether less information was missed. Conclusions: This project enabled a safer handover to be adopted. The RCoA ACSA aims for >75% documentation, and >10% improvement in stakeholder perception scores were achieved. Work will now focus upon targeting groups with poor uptake (e.g. locums), and obtaining more stakeholder interviews. Further improvements could include computerisation and remote access of handover documents. 1.Eggins S, Slade D. J Public Health Res 2015; 4: 6662.Robertson ER, Morgan L, Bird S, Catchpole K, McCulloch P. BMJ Qual Saf 2014; 23(7): 600–73.Royal College of Anaesthetists. Anaesthesia Clinical Services Accreditation Standards; 2021" @default.
- W4312238126 created "2023-01-04" @default.
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- W4312238126 date "2022-10-01" @default.
- W4312238126 modified "2023-10-16" @default.
- W4312238126 title "QI initiative to introduce a formal anaesthetic shift handover in a district general hospital" @default.
- W4312238126 doi "https://doi.org/10.1016/j.bjao.2022.100035" @default.
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