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Improving patient handover between teams using a business improvement model: PDSA cycle.
Br J Hosp Med (Lond). 2014 Jan;75(1):44-7
Authors: Luther V, Hammersley D, Chekairi A
Abstract
BACKGROUND: Medical admission units are continuously under pressure to move patients off the unit to outlying medical wards and allow for new admissions. In a typical district general hospital, doctors working in these medical wards reported that, on average, three patients each week arrived from the medical admission unit before any handover was received, and a further two patients arrived without any handover at all. A quality improvement project was therefore conducted using a 'Plan, Do, Study, Act' cycle model for improvement to address this issue.
METHOD: P - Plan: as there was no framework to support doctors with handover, a series of standard handover procedures were designed. D - Do: the procedures were disseminated to all staff, and championed by key stakeholders, including the clinical director and matron of the medical admission unit.
RESULTS: S - STUDY: Measurements were repeated 3 months later and showed no change in the primary end points. A - ACT: The post take ward round sheet was redesigned, creating a checkbox for a medical admission unit doctor to document that handover had occurred. Nursing staff were prohibited from moving the patient off the ward until this had been completed. This later evolved into a separate handover sheet. Six months later, a repeat study revealed that only one patient each week was arriving before or without a verbal handover.
CONCLUSIONS: Using a 'Plan, Do, Study, Act' business improvement tool helped to improve patient care.
PMID: 24401971 [PubMed - indexed for MEDLINE]