Patient Safety & Clinical Handover

Kiaran Flanagan, Consultant Acute Physician

Acute Medicine Team

Acute Medicine

Acute Medicine

• Busy

• Lots of sick people

• Lots of doctors

• Wide spectrum of practice

• You have to keep you eye on the ball...

• HIGH RISK AREA OF CLINICAL PRACTICE

What is our minimum standard?

“The very first requirement in a hospital is it that it should do the sick no harm”

Notes on Hospitals, 1863

What is patient safety?

Or ...

Our Aim

No needless deathsNo needless pain or sufferingNo unwanted waitsNo helplessnessNo waste

For anyone....

The scale of the problem

Factors Affecting Patient Safety

• Patient

• Task

• Individual

• Team

• Working Conditions

• Organisational

• Governmental & Regulatory

A couple of little stories...

Fell over on the way to the shed

Fell over on the way to the bathroom

Fell over on the way to the kitchen

Its all about cheese...

Never Events

Human Factors

What is Clinical Handover?

The transfer of professional responsibility and accountability for some or all aspects of care for

a patient, or group of patients, to another person or professional group on a temporary or

permanent basis

National Patient Safety Agency, 2005

The transfer of professional responsibility and accountability for some or all aspects of care for

a patient, or group of patients, to another person or professional group on a temporary or

permanent basis

National Patient Safety Agency, 2005

Why Clinical Handover?

Continuity of sufficient and relevant information(and

appropriate action) to suitably experienced clinicians is vital to the

safety of our patients

Continuity of sufficient and relevant information(and

appropriate action) to suitably experienced clinicians is vital to the

safety of our patients

Responsibility & Accountability

“Individuals and organisations have a shared

responsibility to ensure that safe continuity of

information and responsibility takes place”

“Information provided during handovers

influences the delivery of care for the whole

shift”

What it’s supposed to achieve

• Sufficient and relevant information should be exchanged

• Clinically unstable patients made known to senior and covering clinicians

• Unstable patients receive review

• Juniors adequately briefed of concerns from personnel and previous shifts

• At risk areas/ situations identified

Getting practical

• Morning Clinical Handover 08:30 CDU

• Evening Clinical Handover 17:00 ED Seminar

Room

• H@N Clinical Handover 20:30 Control Room