Quality Improvement Through Effective Staff Handover

Ms. Simone Comiskey.
Quality & Safety Manager ,
St. Mary's Hospital
Quality Improvement Through
Effective Clinical Handover.

Aims for today's presentation
 To describe the rationale, background and how
The Elms Ward implemented the Productive
ward, clinical shift handover project
 Discuss effective clinical handover process with
patient goals and improved outcomes as central
to the communication process.
 Outline supporting resources to support
communication in handover.

Rationale for project
Clear communication & clear accountability was
identified as a recommendation following a
systems analysis review of a serious reportable
event in 2015.
Communication was a key common theme for all
the recommendations that emerged from the
systems analysis review.

Focus of the project
 Releasing Time to Care – Productive Ward -
adoption of the productive ward series.
 Empowering staff to make positive changes to the
way they work
 Improving efficiency & enhancing the patient
outcomes & experiences
 improving staff morale.
 Genuine MDT synergy & collaboration to improve
patient care and safety

Funding & How we applied the
productive ward funding
 St. Mary’s Hospital applied to Nursing & Midwifery Planning &
Development , HSE Dublin North , Nursing and Midwifery
Innovation funding to support the productive ward project .
 The productive ward licence purchased for 23 beds @ cost of
1380.
 A external facilitator delivered a 1 day introduction to productive
ward series to Multidisciplinary staff .
 Training was beneficial & motivated staff to begin the
series & examine current practices that contributed to
patient care.
 Handover boards designed
www.visualsystemshealthcare.co.uk
 Patient bed boards with assigned nurse identified for the shift.

Hand over project – preparation
 Deep diagnostic assessment of work practices.
 Ward Handover audited for a base line assessment /starting
point .
 A list of what subject matter handed over was noted. This list
was presented to staff & asked to dot vote what they felt was
important to hand over from shift to shift.
 Staff education :The HSE/shift handover training programme for
nurses and Health Care assistants Midlands Regional Hospital ,
Tullamore, Co. Offaly (2014) www.HSE.ie/shifthandover.ie
 Consensus was sought for all changes to ward practices.
 Nursing forum: met every 2 months , led by Director of Nursing.
This gave the project the urgency for change .
Made the project a priority.
Made a significant impact to boost the change process
Mapped the change process.

“On the move”(NHS, 2008)
 Concept incorporates 3 components relating to
a) location of handover
b) Receiving handover standing at the patient
communication board.
c) Meet and greet : opportunity to introduce staff
and patients, while exchanging relevant
information at the bedside while facilitating a
person centred approach.

Preparation for handover
The nurse giving handover ensures
 that the white board is updated
 Ensures that all care plans , assessments and
nursing notes are up to date and accurate .
 Any care plan/ assessments that are not up to
date and the nurse cannot complete before the
end of shift time is communcated to next shift on
the white board .

Preparation for shift – allocation of
staff
 Identify specific roles and responsibilities ,
 Staff are fully aware of where they are allocated
to , who they are working with , who is the nurse
in charge.
 Clear allocation of staff nurses and HCAs to
named patients and allocated rooms .
 Each HCA Is allocated to a named nurse

New Clinical Handover process
Where :Ward handover commences at white board.
Who: All Nursing & Health Care Assistants
When : At allocated shift handover times
What : information is to be handed over
ISOBAR Communication tool used for handover
sheet
 Safety Pause :Identifies specific safety issues “heads
up” for the forthcoming shift &High alerts handed over.
 Key priorities for this shift clearly communicated to
staff using the ISOBAR Communication tool.

Structured standardised approach to
handover to achieve key objectives
 Improved patient outcomes
 Reduced near miss/adverse events
 Reduce repetition
 Improved patient satisfaction rates
 Enhanced safety and effectiveness in the delivery
of care
 Enhanced education within handover
 Improved quality of information disseminated
 Reduced length of handover time

Quality Improvement Through Effective Staff Handover

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