Patient handovers under scrutiny

18 March 2010

DOCTORS are being asked to report their experiences of the patient handover process as part of a new investigation by the Royal College of Physicians.

Hospital trusts have introduced more shifts since the introduction of the European Working Time Directive in August which restricted junior doctors’ working hours. This has led to concerns of a breakdown in continuity of care as patients are repeatedly handed over to different shifts "leading to potential and actual harm", the RCP has said.

The College has launched an investigation into handover systems in a bid to improve the process of transferring care from one medical team or consultant to another.

In a study simulating handovers using fictional patient scenarios, junior doctors given verbal handovers forgot 67 per cent of the information after the first handover and 97 per cent by the fifth handover. Groups taking notes retained 87 per cent of important data with 85.5 per cent retained after the fifth handover. Another study showed that a structured handover form increased information retention from 73 per cent (plain paper notes) to 93 per cent.

The RCP warned that changing shift patterns should not detract from the ultimate responsibility of doctors for ensuring that their patients are safe, diagnosed efficiently and treated effectively. But despite established standards for the structure and content of handover documents, take-up is not universal and the procedure is still handled differently in each hospital.

The RCP’s project will start with a survey examining the various barriers to good handover practice. An email invitation will be sent out to all UK doctors inviting them to take part in the online survey. The results will be presented to a meeting at the College on May 20.