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Abstract
Aims To assess adherence to RCS ‘Safe Handover’ guidelines out-of-hours (OOH) within a general surgery department and identify areas in which handover practices can be improved.
Methods 10 OOH surgical handovers were audited in September 2023 against RCS ‘safe’ handover guidelines. Results were analysed and presented in the local departmental audit meeting. Presentation slides with our findings were circulated within general surgery and a handover template with key aspects of RCS handover guidelines was created, included in departmental inductions and placed on the handover table as a physical prompt. In November 2023 a further 10 OOH handovers were re-audited.
Results Various aspects of the RCS ‘safe’ handover performance descriptors demonstrated significant improvement. The Patient brief (80% from 0%) and educational opportunities (80% from 0%) showed greatest improvement. Audibility of only one speaker (90% from 30%), rollcall performed (70% from 10%), clarity of patient management plans (90% from 50%), and awareness of on-call overnight consultant (80% from 30%) also improved.
Conclusion Introducing a handover template during OOH general surgery handovers demonstrated improved adherence to RCS guidelines. Consistency is required to maintain both patient and doctor safety considering the frequent rotation of doctors. Educational opportunities were improved here and must be maximised following the European Working Time Directive (EWTD) and transition to shift-based working.
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