quality improvement through effective staff handover
Post on 22-Jan-2018
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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.
www.hse.ie/shifthandover.ie
“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
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