Background and aims The implementation of European working time directive and shift patterns of working has highlighted the importance of good handovers in Paediatrics. Current guidance from RCPCH and GMC stress the importance of good handovers. We present a closed loop audit cycle of handover practice, process mapping, the organisational strategies which resulted in use of standardised handover proformas, reducing potential for clinical errors and improved handovers in a district general hospital (~4000 paediatric inpatients a year).

Methods Data was collected assessing the handover process using 19 parameters, which included - timing, duration, structure, documentation, facilities and facets of clinical care, over a 2 week period. Changes were introduced following the audit and a re-audit was carried out with same parameters.

Results 604 patients were handed over in 2 weeks (32 handovers) during the initial audit. 69% of handovers were delayed greater than 5 min and finished beyond the designated time on 50% occasions. Average duration was 25 mins with 17 interruptions during 2 week period.

Changes were implemented following the audit, which involved organisational strategies:

Safety briefing

Handover proceedings sheet

Structured handover sheet

Training sessions

SBAR handover tool

Bleep free period for handover (except emergencies)

The re-audit showed significant improvement in all parameters monitored and resulted in improved patient safety and quality of care.

Conclusions The use of structured handover format and the above organisational strategies has resulted in improvement in the efficacy and efficiency of data transfer during patient handover and good clinical documentation, resulting in improved patient safety and quality of care.