The F.R.I.D.A.Y.S. checklist - Preparing our patients for a safe weekend

Palmer, Edward; Richardson, Emma V.; Newcombe, Hannah; Borg, Cynthia-Michelle

doi:10.1136/bmjquality.u660.w502

Cited by 10 publications

(7 citation statements)

References 11 publications

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“…The simplicity of the checklist made it possible for the staff to reduce the number of routine tasks for the weekend. 8 As with our problem, the study showed how routine tasks can continue on the weekend, just as our routine tasks continue during the evening and night.…”

Section: Introductionmentioning

confidence: 84%

Reducing potentially avoidable tasks in a hyperacute stroke unit

Tireli

2021

BMJ Open Qual

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The workflow in a stroke unit can be very high, and this is especially noticeable during evening and night shifts, where staffing is reduced but the patient’s need for frequent and intensive care is not. The specialised and standardised settings in a stroke regime are constant and demanding for healthcare providers who, therefore, must work efficiently. Patient admissions, acute situations and routine tasks are major contributors to the burden of work during evening and night shifts for junior doctors on call. Thus, it is important to reduce the number of potentially avoidable tasks done by these junior doctors during night shifts so they have more time to perform tasks of high priority. The aim of this project was to reduce the potentially avoidable tasks occurring at night for the on-call junior doctor to only one per shift. We investigated the types of tasks that frequently occur for the on-call junior doctor during the night shift and improved our daily morning and evening rounds to reduce the number of tasks during the night shift. Using the plan–do–study–act method, we made improvements through education, knowledge sharing, checklists and feedback, and we reduced the number of potentially avoidable tasks for on-call junior doctors from a median of 11 to a median of 3 per week, demonstrating that the workload for the on-call junior doctor during the night shift can be reduced through a systematic approach to improving the work routines of doctors and nurses.

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Section: Introductionmentioning

confidence: 84%

Reducing potentially avoidable tasks in a hyperacute stroke unit

Tireli

2021

BMJ Open Qual

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“…Previous quality improvement (QI) projects, looking at handovers, trialled several systems, such as paper lists, proformas, stickers for insertion into notes and computer-based tools (Din et al, 2012;Ashton, 2014;Bethune et al, 2014;Jardine et al, 2014;Raptis et al, 2009;Govier and Medcalf, 2012;Palmer et al, 2014). These systems have strengths and weaknesses.…”

Section: Introductionmentioning

confidence: 99%

Improving out-of-hours surgical patient care

Hart

Samways

Kukendrarajah

et al. 2018

International J Health Care QA

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Purpose -The Royal College of Surgeons recognises patient handover as the point at which patients are collectively at their most vulnerable. Concerns were raised in a London teaching hospital surgical department regarding an unstructured handover system, poor access to relevant clinical information, and inadequate weekend staffing. A quality improvement programme was designed and implemented to respond to these concerns and improve patient safety. The paper aims to discuss these issues. Design/methodology/approach -A structured questionnaire was distributed to staff and results used to construct a diagram outlining the main factors influencing weekend patient safety. This framework was used to design changes, including a new electronic handover tool, regular handover meetings and additional weekend staff. Regular staff training was provided, and success was assessed in a continuous audit cycle with the results fed back to team leaders. Findings -Over a three-month period, the handover meeting recorded an attendance rate consistently above 80 per cent. The electronic handover entries were scored according to seven criteria (correct layout; key information, i.e.: patient location, clinical priority, active issues, resuscitation status, test results and weekend plan), averaging between 42.2 and 92.9 per cent, with progressive improvement seen over the assessment period. Weekend staffing was increased by 50 per cent, allowing a dedicated team to care for stable inpatients and to oversee discharges. Originality/value -This improvement programme delivered lasting and significant change in response to staff concerns. It resulted in a more structured and reliable weekend system and established key mechanisms for dynamic performance feedback.

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“…They demonstrated the use of an electronic weekend handover in helping to improve patient safety and continuity of care. [6][7][8][9] The RCP identified a handover as "a major cause of preventable harm" and this forms the fundamental basis for this project. 4 …”

Section: Introductionmentioning

confidence: 99%

Introducing a New Junior Doctor Electronic Weekend Handover on an Orthopaedic Ward

Maroo

Raj

2017

BMJ Qual Improv Report

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Junior Doctors working on the Orthopaedic wards at a district general hospital identified the lack of a formal weekend handover. The Royal Colleges,GMC and Foundation Programme curriculum all emphasise the importance of a safe and effective handover. Doctors found that the current system of using a written, paper-based handover was unreliable, un-legible, and inefficient. Baseline measurements were sought in the form of a questionnaire which allowed us to obtain the limitations to the current handover. After this and a focus group, a new electronic, 'Microsoft Word' based handover was created and a repeat surgery issued in 2 weeks. Further PDSA cycles over the course of 8 weeks helped to improve and implement the new handover. The overall rating, out of 10, of the new handover increased from 3.4 to 8. Doctors felt the new handover was safer for patients and could be used as a tool for reviewing or referring patients. This project describes the use of a simple, cost-effective intervention that helped to improve patient safety and staff satisfaction. PROBLEMThe junior doctor weekend handover within the orthopaedic department at Pilgrim Hospital, Boston (United Lincolnshire Hospitals NHS Trust) was felt to be sub-optimal.The department is made up of two 29-bed Trauma and Orthopaedic wards: one trauma and one elective ward. The doctors working on these wards were only responsible for the patients under the care of the orthopaedic team. Surgical and medical outlier patients were excluded. In the past, each junior doctor working in either of the two wards were responsible for generating a list of jobs for the weekend on-call junior doctor team to complete. These included and were not limited to: chasing bloods, reviewing patients and ordering investigations. It was then the responsibility of the Foundation Year 1 Doctor, providing cover for the wards, to obtain this list from the ward desk or in person, from a junior doctor on the wards during the week, and carry out the jobs stated. When solely taking care of approximately sixty orthopaedic patients and having a poorly communicated handover provided to you on loose sheets of paper, within a blank book of notes or even verbally, the task of taking care of these patients seems momentous.Informal opinions of Junior Doctors found that this handover was unreliable, un-legible, and inefficient and there was no standardised format, timing or emphasis put on its importance. As a result, a number of jobs, such as chasing blood results, were not being completed by the weekend team and subsequently putting patient safety at risk.The SMART aim of the project was asses the opinion of the current handover with a staff questionnaire and subsequently phase out the current written handover by creating and implementing an affordable, safe and effective electronic handover based on the opinions of junior doctors within an 8-week time-frame. The team involved in this project included myself, as author and my named supervisor. The participation of all junior doctors in focus grou...

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The F.R.I.D.A.Y.S. checklist - Preparing our patients for a safe weekend

Cited by 10 publications

References 11 publications

Reducing potentially avoidable tasks in a hyperacute stroke unit

Reducing potentially avoidable tasks in a hyperacute stroke unit

Improving out-of-hours surgical patient care

Introducing a New Junior Doctor Electronic Weekend Handover on an Orthopaedic Ward

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