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MEDICAL HANDOVER.
TAPS – TRAINING AND ACTION FOR PATIENTS SAFETY.
C. Ruprai, M. Kotlinska, C. Brewer, A. Wilson, Mrs. Jha
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What is TAPS?
New training programme
↓
Helping multi-professional clinical teams
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Develop innovative solutions
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Address common patient safety problems
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TAPS programme
• Designed by Bradford Institute for Health Research and panel of active clinicians
• Running across Yorkshire (inc. Bradford, Leeds, Sheffield, Doncaster, York)
• 10 teams in Hull (inc. Acute Medicine, Orthopaedics, Pharmacy)
• O&G team: C. Ruprai, M. Kotlinska, C. Brewer, A. Wilson, Mrs. Jha
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Medical handover
Poor handover has repeatedly been implicated as a causative factor in adverse incidents
&
improvement in handover has been advocated by a number of agencies
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Challenges
• EWTD• Increase patient load• Frequent movement of patients• Involvement of multiple specialist team• Corridor or inconvenient meeting room• Type, formality & information varies• Interruptions
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TAPS
20 week programme
November 2011 – March 2012
4 workshops
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1st staff survey (Nov. 2011)
Results presented at Joined Obs.&Anaest. Meeting
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Handover audit (presented in PNM Dec. 2011)
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TAPS
↓ Introduction of unified handover sheet (Jan. 2012)
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Weekly audits for 10 weeks
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2nd staff survey
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Your perception of handover
• 2 staff surveys (November 2011 and March 2012)• The questionnaire was randomly given to different levels of staff
• 46 participants in first one and 33 in the second one
• Obstetric, midwifery and anaesthetic members of staff
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Results
• Perception of O&G consultant presence at the handover 74%
• Evident absence of the anaesthetic staff• 70% - appropriate setting of the handover • Average score for quality of the handover across all staff was 3.6 (scale 1-5)
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Weekly audit
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Weekly audit
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Who is consistently present at handover
2nd survey
1st survey
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On time start of handover
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Who leads handover
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Have you been pulled out of handover for non-urgent tasks
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Setting (quiet and private)
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Overall quality of handover
Overall 3.6
Overall 3.8
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Is there consistent handover between O&G SpR and consultant
between 5-7pm
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Conclusion
• Excellent morning handover involving whole MDT
• Clear improvement in many areas of the handover in TAPS process
• Audit once a year is not good enough tool in monitoring change and hence should be undertaken more frequently
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Recommendations
• Evening face-face communication between obs. SpR and consultant needs to be improved, already has been communicated to senior staff
• Repeat staff survey in next several months• Share the experience with others (our ‘journey’ may be used to help improve medical handover in other clinical areas)
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Thank you