Improving physician handover documentation process for patient transfer from paediatric intensive care unit to general ward

• Published in: BMJ open quality Vol. 9; no. 4; p. e001020
• Main Authors: Alali, Hamza, Antar, Mohannad, AlShehri, Ali, AlHamouieh, Ousaima, Al-Surimi, Khaled, Kazzaz, Yasser
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.12.2020; BMJ Publishing Group
• Subjects: Communication; Critical care; Documentation; Health administration; Intensive care; Medical records; Patient safety; Pediatrics; Physicians; Quality control; Quality improvement; Quality Improvement Report; paediatrics; hand-off; quality improvement
• ISSN: 2399-6641; 2399-6641
• DOI: 10.1136/bmjoq-2020-001020

BackgroundInadequate handover communication is responsible for many adverse events during the transfer of care, which can be attributed to many factors, including incomplete documentation or lack of standardised documentation process. The quality improvement project aimed to standardise the handover documentation process during patient transfer from paediatric intensive care unit (PICU) to the general paediatric ward.MethodsData analysis revealed lack of proper handover documentation with the omission of vital information when transferring patients from PICU to general ward. The quality improvement team assessed the current handover documentation practice using a brainstorming technique during multiple meetings. The team evaluated the process for possible causes of incomplete handover documentation, framed the existing challenges, and proposed improvement interventions, including a standardised handover form and conducting education sessions for the new proposed process. The main quality measures included physician’s compliance with handover documentation elements, physician’s satisfaction and PICU emergency readmission rate within 48 hours.ResultsPhysician compliance to handover documentation improved from 29.5% to 95.5% before and after implanting the improvement interventions, respectively. The level of physician satisfaction with the quality of communicated information during the handover process improved from 47.5% to 84%, and the PICU emergency readmission rate declined from 3.8% to zero after all improvement interventions were implanted.ConclusionImplementation of standardised handover form is essential to improve physician compliance for clear handover documentation and to avoid data omission during the patient transfer process. Documented handover in patient’s medical record has positive impact on physician satisfaction when managing patients recently discharged from PICU.