Medical handovers across shifts within a five-day-working model: results from an electronic handover system in an acute NHS trust

Abstract

Electronic handover tools have been advocated as a potential strategy to improve the quality of handover, especially during on-call periods at night and weekends. We aimed to quantify, categorise and explore the temporal relationship of handover tasks stored on an electronic handover system (eHandover) in an acute UK hospital trust in which the day-time primary team worked only weekdays, with only the day-time and night-time on-call teams being available at weekends. Second, we evaluated whether tasks that remained in the eHandover system throughout several shifts were likely to be completed. We defined the shift gap as the number of clinical shifts that passed between the creation of the handover task and its completion. 11,071 electronic handover parcels created on eHandover between March 2010 and January 2011 were analysed. More handovers were requested for completion on weekends (70 parcels a day) than on routine weekdays (22 parcels a day; p<0.001). The receiving teams reported that 89.4% (9,900) of the handover parcels were completed. Greater amounts of handover work was requested over weekends, when tasks were often transferred across many clinical shifts. Despite this, task-completion rates on eHandover remained consistently high. The use of a well-designed electronic handover system as part of a systematic intervention, in combination with organised verbal handover meetings, can help to reduce the risk of communication failure across shifts.