Background At Compton Care specialist palliative inpatient unit, an electronic document is used to handover pertinent information to doctors providing out of hours cover, alongside a verbal handover. Doctors on call may not be based at Compton Care during working hours. The document is also used day-to-day to communicate ongoing issues. A review of this document was felt to be required to ensure safe, accurate and efficient transfer of patient information.
Methods Individuals who use the document were surveyed. The effectiveness of communication of the information was evaluated. Views regarding what the document should contain were also gathered. A PDSA cycle approach was adopted: change was driven by survey results and by current accepted practice according to literature and Royal College of Physicians guidance. Patient confidentiality and GDPR regulations were considered when reviewing the document.
Results Of those surveyed 30% did not fully understand what all parts of the document were communicating. The document was reformatted and a description key was added, subsequently increasing understanding to 100%. A description of the handover document is being included in the induction pack given to new doctors on commencing work. Inclusion of ‘ceiling of escalation’ was supported by 100% and therefore added. Sections for ‘preferred place of death’ and ‘discharge information’ were added as they had been supported by more than 50%. Inclusion of drop down boxes was felt to be helpful in reducing the time taken to update information.
Conclusions Clear communication of pertinent patient information and patients‘ wishes will reduce errors and ensure better patient care when making decisions out of hours. Electronic patient software that can be accessed remotely has been introduced recently to Compton Care. This is likely to affect how and what information is handed over; further review will be carried out in approximately one year.
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