Background and aims Handover of patients between shifts is an important process, to ensure continuity of care and that important information is communicated to the appropriate personnel. It should be completed in a timely and efficient manner. Interruptions should only be for emergencies or essential clarification. In a large teaching hospital information regarding up to 80 patients needs to be communicated in a half an hour window every morning to a number of subspecialities. Late arrivals delay the start of this process and prolong the duration. Frequent interruptions may disrupt the process.

We aimed to evaluate the start time, duration, personnel present and interruptions of morning handover in a tertiary centre.

Methods 10 days August to October 2015 were selected and analysed looking at start time and duration of handover, personnel present, whether or not safety briefing was performed and any late attendences, interruptions and non urgent phone calls.

The standard was that the safety briefing should be completed 100% of the time and that handover should start on time and there should be no late arrivals.

Results Handover on average started 5 min late each morning and 8/10 times the safety briefing was not performed. An average of 3 people were late to handover each morning and on average 2 non urgent phone calls were received each handover. Late attendance and interruptions positively correlated with length of handover with values of 0.48 and 0.45 respectively.

Conclusions We concluded that there are too many interruptions which are frequently non urgent. Phone calls from nursing staff about routine tasks were frequent. The delay in starting handover and the duration impacted on the ability of teams to commence ward rounds in a timely manner.

Following this audit, we have implemented a reminder about handover etiquette including 10 rules and have provided nursing staff with up to date information about handover timings and the appropriateness of phone calls.

Following this intervention a re-audit is underway.