Northern Ireland general surgery handover study: Surgical trainees' assessment of current practice

Kennedy, Robert; Kelly, Susan Harrison; Grant, Scott B.; Cranley, Brian

doi:10.1016/s1479-666x(09)80060-7

Cited by 13 publications

(5 citation statements)

References 3 publications

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“…Australian ASU study found that surgeon-to-surgeon handover did not affect patient outcomes, 23 while in the UK, ASU trainees reported greater satisfaction with handover practices. 24 Similarly, our study found that standardised patient handover was more likely to occur in ASU models. However, such rules' existence in only 45 per cent of ASUs was lower than expected, given the model's need for frequent handover.…”

supporting

confidence: 65%

Emergency general surgery models in Australia: A cross-sectional study

Kinnear

Han

Tran

et al. 2019

amj

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Background Emergency general surgery (EGS) patients experience superior outcomes when cared for within an acute surgical unit (ASU) model. However, the EGS structures in most Australian hospitals remain unknown. Aims This study aimed to describe the national spectrum of EGS models. Methods Surgical staff were contacted in all Australian public hospitals of medium (>2,000 patient separations perannum) or greater peer group. Primary outcomes were incidence of each EGS model. Secondary outcomes were the relationship of EGS model to objective hospital variables, and qualitative reasons for choice of model. An ASU allocated a general surgeon solely to EGS patients for ≥50 per cent of business hours. A Hybrid model did not have this feature, but provided either a doctor-in-training rostered solely to EGS for ≥50 per cent of business hours, or ≥2 protected theatre half-day EGS lists per week. Results One hundred and nineteen of 120 eligible hospitals participated (99 per cent). Sixty-four hospitals (54 per cent) reported utilising hybrid model. ASU implementation was significantly more common amongst hospitals of greater peer group (p<0.0001), bed number (p<0.0001), surgeon pool (p=0.0003) and trauma service sophistication (p=0.0002). Leading reported drivers for ASU commencement were aims to improve EGS patient care and decrease after-hours operating, while common barriers against ASU uptake were insufficient EGS patient load or surgeon on-call pool. Conclusion ASU or Hybrid models of care for EGS patients may be more widespread than currently reported. Introduction of such structures is heavily dependent on hospital and staff size, trauma subspecialisation and EGS patient throughput.

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supporting

confidence: 65%

Emergency general surgery models in Australia: A cross-sectional study

Kinnear

Han

Tran

et al. 2019

amj

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“…There has also been some discussion of the use of mnemonic devices to guide handover, although there is a paucity of evidence as to their effectiveness 14 . Despite these innovations, research has identified dissatisfaction amongst junior staff 15 with current practices as a result of the lack of policies and training 16 . There have been calls for formal handover education 17 and work has started to clarify competencies for training 18 .…”

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confidence: 99%

Educational interventions to improve handover in health care: a systematic review

2011

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“…A study in Northern Ireland demonstrated that 53% of surgeons had no handover policy and another 11% were unsure whether they did or not; 87% of surgical trainees had no guidance for handover, and 86% felt current handover practices were unsafe. 39 Our questionnaire demonstrated that most respondents felt their handovers were safe (61%) and efficient (69%). Similar to participants in the study by Kennedy and colleagues, 39 less than 15% of participants in our study reported having a hospital protocol for handover or using their own checklists, and only 22% said they had a handover protocol for their group.…”

Section: Instructionsmentioning

confidence: 84%

“…39 Our questionnaire demonstrated that most respondents felt their handovers were safe (61%) and efficient (69%). Similar to participants in the study by Kennedy and colleagues, 39 less than 15% of participants in our study reported having a hospital protocol for handover or using their own checklists, and only 22% said they had a handover protocol for their group. Approximately 41% of our respondents were taught handover techniques as trainees, and 94% felt that it was important to teach trainees the proper procedure for handover, which is supported in the literature.…”

Section: Instructionsmentioning

confidence: 84%

Development of an orthopedic surgery trauma patient handover checklist

et al. 2014

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Development of an orthopedic surgery trauma patient handover checklistBackground: In surgery, preoperative handover of surgical trauma patients is a process that must be made as safe as possible. We sought to determine vital clinical information to be transferred between patient care teams and to develop a standardized handover checklist. Methods:We conducted standardized small-group interviews about trauma patient handover. Based on this information, we created a questionnaire to gather perspectives from all Canadian Orthopaedic Association (COA) members about which topics they felt would be most important on a handover checklist. We analyzed the responses to develop a standardized handover checklist. Results:Of the 1106 COA members, 247 responded to the questionnaire. The top 7 topics felt to be most important for achieving patient safety in the handover were comorbidities, diagnosis, readiness for the operating room, stability, associated injuries, history/mechanism of injury and outstanding issues. The expert recommendations were to have handover completed the same way every day, all appropriate radiographs available, adequate time, all appropriate laboratory work and more time to spend with patients with more severe illness. Conclusion:Our main recommendations for safe handover are to use standardized checklists specific to the patient and site needs. We provide an example of a standardized checklist that should be used for preoperative handovers. To our knowledge, this is the first checklist for handover developed by a group of experts in orthopedic surgery, which is both manageable in length and simple to use.Contexte : En chirurgie, le transfert préopératoire des polytraumatisés nécessi-tant une chirurgie est un processus que l'on doit rendre aussi sécuritaire que possible. Nous avons voulu déterminer quels renseignements cliniques vitaux doivent être transmis aux équipes de soins et préparer une liste de vérification standardisée à cette fin.Méthodes : Nous avons réalisé des entrevues standardisées par petits groupes au sujet du transfert des polytraumatisés. À partir des renseignements recueillis, nous avons élaboré un questionnaire pour obtenir le point de vue de tous les membres de l'Association canadienne d'orthopédie (ACO) au sujet des élé-ments jugés les plus importants sur une liste de vérification en vue du transfert. Nous avons analysé les réponses pour dresser une liste de vérification standardisée.Résultats : Sur les 1106 membres de l'ACO, 247 ont répondu au questionnaire. Les 7 éléments jugés les plus importants pour assurer la sécurité des patients lors du transfert ont été : comorbidités, diagnostic, état de préparation pour le bloc opéra-toire, stabilité, blessures connexes, histoire et mécanisme du traumatisme et questions en suspens. Les recommandations des experts ont été les suivantes : que les transferts s'effectuent de la même façon chaque jour, qu'on obtienne toutes les radiographies appropriées disponibles, qu'on dispose de temps suffisant, qu'on obtienne toute les analyses de lab...

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Northern Ireland general surgery handover study: Surgical trainees' assessment of current practice

Cited by 13 publications

References 3 publications

Emergency general surgery models in Australia: A cross-sectional study

Emergency general surgery models in Australia: A cross-sectional study

Educational interventions to improve handover in health care: a systematic review

Development of an orthopedic surgery trauma patient handover checklist

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