Electronic handover (eHandover): towards safer medical care

Quality Improvement Team:Dr. Adam Hexter, FY1 Doctor at Manchester Royal Infirmary, CMFTMr. Stuart Morrison, IT Business Analyst (Specialist Medicine & Surgery), CMFTMr. David Van Dellen, Transplant Surgeon, CMFT

Handover: Service DeliveryGeneral SurgeryWord document handover template only accessible on one computer

Clinical Audit (August – September 2013)Poor compliance with Royal College of Surgeons standard

Handover Item Compliance

Clinical presentationInvestigations/resultsBed numberEarly warning score

82%63%20%4%

Suboptimal service delivery

Handover: Working EnvironmentQuestionnaire of current FY1s (n=26) at CMFT, January 2014

•74% - current handover template / patient list is inefficient

•68% - spend >20 minutes/day updating basic details

•One-computer access – spend >30 minutes/days on average walking/waiting

Suboptimal working environment

Electronic Patient Record (EPR)

Electronic-based ‘live-list’ for all current inpatientsAutopopulates basic information: demographics, consultant, location, EWS etc.

eHandover platform

Functionality

•Alerting if a handover task if overdue•Integration with EPR – transparency•Handover uniformity across specialties•Everything is recorded and auditable•Compliance with BMA, RCP & RCS guidance

Cost AnalysisThe £1500 will be used to pay for the customisation work required to make the facility work on any appropriate mobile device.

Time Frame: Q2 financial year 2014/15Surgical division has highlighted this as an area of priority

SWOT AnalysisSTRENGTHS

PatientsStaff • accessible throughout the trust• flexible and time-saving • specific instructions for nights/weekends• training/educationNHS• consistency across specialties• transparency • weekend discharges

WEAKNESSES• cultural shift • locum doctors (access)

OPPORTUNITIES• ongoing EPR support• dissemination• paperless NHS

THREATS• Caldicott

Technology in Medicine

Government Target: NHS should be paperless by 2018

RCP: in the current technological climate, where possible, electronic handover processes should be encouraged.

Thoughts of current FY1s at CMFT:•96% - welcome eHandover and deem it essential•96% - improve working environment •100% - improve patient safety

Expansion

Summary of Our Bid£1500 towards development for electronic portable devices

Health Secretary, Jeremy Hunt: “Only with world class information systems will the NHS deliver world class care”