P070: Improving handovers in the emergency department: implementation of a standardized team approach

Abstract

to additional training. Our study emphasizes that our physicians have the skill set to identify and provide care for sepsis using their clinical judgment in cases that may not require protocolized based care.

Development and implementation of a standardised emergency department intershift handover tool to improve physician communication

“…At the study outset, no standard format for physician-to-physician handover between shifts was being used in our ED. Previous resident research within our department confirmed that patients admitted to inpatient care or referred to a consultant service (‘boarded patients’) but not yet seen were frequently omitted from intershift handover communication between ED physicians 7 8. Additionally, informal observations of handovers leading up to this quality improvement (QI) initiative revealed that up to 25% of patients still in active care of the ED team (eg, pending discharge or transportation) were often omitted from handovers between ED physicians, and up to 50% of patients referred to specialty consultants were omitted from these handovers.…”

“…We performed a literature review of published articles describing handover practices, that focused on ED-specific models and experiences with demonstrated positive quality and safety improvements 1 3 4 7 8 10 12 14 16–18 20–23 25. There is no gold standard that is currently accepted to define ‘adequate’ ED intershift handover.…”

“…There is no gold standard that is currently accepted to define ‘adequate’ ED intershift handover. Local quality improvement and patient safety experts summarised key learnings from the literature and local observational analysis,7 8 and used them as a framework for leading focus groups in our department.…”