Background Poor inter-professional interactions risk patient safety and contribute to adverse outcomes, error and poor patient care. Standardisation of handover ensures essential information is passed between teams and implementation of closed loop communication removes the doubt as to whether essential patient information has been received and understood, thus improving patient care and team working.
Aim To improve paediatric patient handover by standardising communication using the Medical Protection Society (MPS) “S. H. I. F. T” handover tool with the ultimate aim of reduction of errors relating to poor communication and improved patient care.
Methods We assessed team opinions of pre-SHIFT handover strategy through a questionnaire. The SHIFT handover model was introduced through a teaching session outlining the key headings – Status, History, Investigations, Fears/Concerns, Tasks and closed loop communication with the receiving team, which were then incorporated into the existing written handover sheet and trialled for a month. We used questionnaires and focus groups to analyse the use of the SHIFT handover model and identify barriers.
Results Pre-SHIFT questionnaires identified dissatisfaction with the previous handover model and a desire for improvement. Using the SHIFT model improved time taken for handover and prevented interruptions during handover, allowing for any essential discussion for personal learning needs to be left until handover completed. Closed loop communication improved engagement with handover and participants felt the SHIFT model made handover more focused.
Barriers to the model included a general dislike of the closed loop communication and perception of increased length of handover time. Lack of empowerment from junior staff to insist on closed loop communication and inappropriate use of the model for long-stay patients were also barriers. Despite these barriers, presenting the patient status, history, investigations, fears/concerns and tasks remain in use in our department.
Conclusion The biggest barrier to the SHIFT model of handover was the closed loop communication. Despite this, its introduction has improved team engagement with handover, reduced inappropriate discussion and ultimately reduced overall handover time and potentially improved patient safety.
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