A Quality Improvement Project to Assess and Refine the Handover Process at Morning Trauma Meetings

Orthopedic Disorder Clinical Trial

Official title:

A Quality Improvement Project to Assess and Refine the Handover Process at Morning Trauma Meetings

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04514601
• Other study ID #: QIP Trauma Meetings Sandwell
• Status: Completed
• Start date: October 23, 2019
• Est. completion date: December 13, 2019

Study information

• Verified date: August 2020
• Source: Sandwell & West Birmingham Hospitals NHS Trust
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This project was intended to observe the handover of trauma and orthopaedic patients at a district general hospital in the UK. Following the implementation of a standard operating protocol, the handover of patient information improved including neck of femur fracture patients significantly. The study can therefore be utilised by other similarly structured departments to improve the handover process, thereby improving patient safety.

Description:

Poor handover and inadequate transmission of clinical information between shifts can result in patient harm. This study was designed to evaluate the impact of implementing a handover protocol on the quality of information exchanged in the trauma handover meetings in a UK hospital.

A prospective single centre observational study was performed at an acute NHS trust, using the Plan-Do-Study-Act (PDSA) methodology. Ten consecutive weekday trauma meetings, involving 43 patients, were observed to identify poor practices in handover. This data was used in conjunction with the Royal College of Surgeon's recommendations for effective handover (2007) to create a standard operating protocol (SOP). Following the implementation of the SOP, a further 8 consecutive weekday trauma meetings, involving a further 47 patients, were observed. The data collection was performed by 5 trained independent observers. The data was analysed using t test for quantitative variables and chi-square or Fisher's exact tests for categorical variables.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 317
• Est. completion date: December 13, 2019
• Est. primary completion date: December 13, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• All patients that were handed over were included in the study.

Exclusion Criteria:

• Nil.

Related Conditions & MeSH terms

• Femoral Fractures
• Femoral Neck Fractures
• Fractures, Bone
• Musculoskeletal Diseases
• Neck of Femur Fracture
• Orthopedic Disorder

Intervention

Other:
• Standard Operating Protocol
This was a written protocol on how the handover process should be conducted.

Locations

Country	Name	City	State
United Kingdom	Sandwell Hospital	West Bromwich

Sponsors (1)

Lead Sponsor	Collaborator
Sandwell & West Birmingham Hospitals NHS Trust

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	To assess the efficacy of the handover of trauma patients going to theatre.	A calculation was performed of how many patients had information handed over to the day staff. This included if a patient's past medical history, investigation results, plan, consent status, mark status and starvation status was handed over either written or verbally. This was expressed as a percentage.	Up to 6 weeks.
Primary	To assess the handover of neck of femur (NOF) fracture patients.	A calculation was performed of how many patients with NOF fractures had information handed over. This included the patient's age, mechanism of injury, past medical history, investigation results, plan, consent status, mark status, starvation status, scoring system calculation and discussion with next of kin regarding resuscitation status. For each of these domains for each patient, if the information was handed over, this was noted and was expressed as a percentage.	Up to 6 weeks.
Primary	To determine if unwell patients were being handed over from the admissions list or patients already on the ward.	From the handover meetings that were observed, it was noted whether 'unwell' patients from the ward had been handed over. This was expressed as a percentage from all the meetings that were observed.	Up to 6 weeks.