Improving the handover process in a psychiatry liaison setting
- PMID: 35264331
- PMCID: PMC8915314
- DOI: 10.1136/bmjoq-2021-001627
Improving the handover process in a psychiatry liaison setting
Abstract
Efficient handover of patient care is integral to clinical safety. Barriers in communication can lead to adverse outcomes. The Integrated Liaison Assessment Team (ILAT) has a daily handover meeting which presents several challenges to the multidisciplinary liaison team (MDT including high patient turnover, differing staff shift-work patterns, presence of visitors/students and lack of a unified approach to structured discussion at times. Areas identified for improvement included optimising efficiency, structure and handover documentation. Lack of teaching and learning opportunities were also identified. The primary aim was to reduce handover time to 30 min. The secondary aims were to improve communication by introducing the Situation-Background-Assessment-Recommendation (SBAR) tool, improve team satisfaction and introduce a teaching programme in the time saved. The Model for Improvement methodology was used with MDT focus groups and questionnaires to explore change ideas. This informed our 'Plan, Do, Study, Act' cycles to design a structured handover. Daily measures looked at handover length and individual team member satisfaction. Weekly measures included semiqualitative questionnaires highlighting areas for improvement. Feedback was gathered from emails and MDT discussions. A structured handover format incorporating SBAR, key task allocation and a shift handover lead was introduced. A regular MDT teaching programme was initiated. Over 4 weeks, 'Good' handover ratings increased from 22% to 65%; 'Poor' ratings decreased from 25% to 8%. Mean handover time decreased from 47 min to 31.25 min; a decrease of 33.5%. Overall, the team viewed SBAR positively as an efficiency-promoting tool. Structured handover has promoted staff competencies, team morale and information sharing practices among ILAT. MDT teaching improved team communication and confidence. Sustaining motivation to keep up interventions and documentation of handover were identified as key areas for sustained improvement.
Keywords: PDSA; hand-off; healthcare quality improvement.
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Conflict of interest statement
Competing interests: None declared.
Figures
References
-
- About Us . Whittington.nhs.uk, 2020. Available: https://www.whittington.nhs.uk/default.asp?c=3920
-
- Royal College of Physicians . Acute care toolkit 1: handover. London: Royal College of Physicians, 2011: 1. https://www.rcplondon.ac.uk/guidelines-policy/acute-care-toolkit-1-handover
-
- NHS England . NHS services, seven days a week. NHS England, 2013: 13–38. https://www.england.nhs.uk/wp-content/uploads/2013/12/brd-dec-13.pdf
-
- Royal College of Psychiatrists . Good psychiatric practice. Dorchester: Henry Ling Ltd, 2009: 12. https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-p...
-
- World Health Organisation Collaborating Centre for Patient Safety Solutions . Communication during patient Hand-Overs: patient safety solutions. Vol 1 Solution 3. WHO Press, 2007. https://www.who.int/patientsafety/solutions/patientsafety/PS-Solution3.pdf
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources