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HANDOVER

PSC POOLE HOSPITAL NHS FOUNDATION TRUST HANDOVER PROJECT TEAM

OUR COLLABORATIVE TEAM

Name Organisational role Collaborative role Away or Home team member*

Val Horn Matron Handover Project Lead Away

Lara Walker

Cara Southgate

Sister

Senior Health Care Assistant

Team Member

Team Member

Away

Jodie Uphill Sister Team Member Away

Nicola Bryan Occupational Therapist Team Member Away

Hayley Elgar Discharge Facilitator Team Member Away

Sally Cobb Deputy Sister Team Member Away

Dr John-Paul Carpenter Dr Georgina Wood

Consultant

Junior Doctor

Team Member

Team Member

Home

Home

Dr Rupert Page Consultant Team Member Home

Dr Brian Lockey Consultant Team Member Home

Lisa BrinkmanTracey Cooper

IT Clinical Nurse Advisors Team Member Away

OUR COLLABORATIVE HANDOVER TEAMTeam Handover – Home and Away!

THE BIG ROOM

THE BIG ROOM – PROMOTING PROJECT INTEGRATION

• Denise Richards

WHAT CHANGE CAN WE MAKE THAT WILL RESULT IN AN IMPROVEMENT

• What solutions do we want to test?

• Design a Trustwide Handover of Care Proforma

• Redesign the current process

• Identify key staff

• Reduce the adverse incidence related to poor handover across the trust

• Improve patient safety and quality

OUR PROJECT

Identified key area for improvement -

Transfer from the Emergency Department to the Assessment Unit

Transfer from the Assessment Unit to the Inpatient Wards

This handover is vital in communicating

• Presenting problem

• Initial diagnosis

• Person specific information

• 1st line intervention

• Immediate care needs

BASELINE DATA/ EVIDENCE OF NEED TO CHANGE

• On average there are 1964 patient transfers per month across the hospital

• 1000 AIRS incident related to Poor Transfer per year

• incorporates medication errors • delay in initial interventions ordered • poor communication• OOHs transfer outside of the Trust Transfer Policy• Sub-standard transfer

• RCA - recommendations

• Complaints/ Patient feedback

TEAM AIMS

Issues to consider:

• What do we need to do to make beds available promptly?

• What standards do we want for transfer?

• How can we speed up transfer and make it safe?

• Who is the best person to handover and how?

• Can we use tools to support us?

METHODOLOGY FOR THE PROJECT TEAM

- Use “ BIG ROOM” approach to redesign the process

- A weekly multi-agency and multi-disciplinary service improvement meeting

- Sharing staff and patient stories

- Review data / PDSA Cycles

- Emerging themes and principles are real-time

- Team work to develop jointly owned solutions to continually improve

PREPARATION

• Prior to First PDSA :

• Define the common principles of safe transfer information

• Identify and agree the pilot areas for the PDSA process

• Design a Handover template• Agree a process for the collection of baseline audit

• Communicate the principles of the project to participating areas

• Scope other Handover projects currently been undertaken in the trust, create links and include key stakeholders

WHAT DID WE FIND?

• No common principles applied across the trust

• Various transfer forms

• Most transfer information is scribbled on nurses handover forms

• All capture different information

• Staff transferring patients not always the staff member who has been involved in caring for the patient in the preceding clinical area

WHERE WE ARE NOW

• Several PDSA Cycles have been managed to support the development of the handover proforma

• PMO have supported the design and template development

• Successful team working in managing the PDSA Cycles

• Collaboration with the Medical IT Handover Development Group commenced

• Collaboration with the E-nurse Assessment Team is in place - two of the IT Clinical nurse advisors have joined the Handover Team

• Information and Risk departments supporting the evidence and data gathering

• Partnership working with the DHCT Handover group

CHALLENGES

• Resistance to Change

• Articulating the objective trustwide

• Need to keep a focused approach

FUTURE PLANS

• PMO to support a baseline audit following patients through the ED and Assessment units – Dates planned

• To widen the test areas for clinical engagement

• Develop guidance and revisit Trust Transfer policy

• Share progress with DHC

• Commence specific handover work between PHFT Trauma unit and Alderney Hospital