Background Sheffield Teaching Hospitals, including the Macmillan Palliative Care Unit (MPCU), is now using a system of handover via the electronic whiteboard (e-handover). Handover is essential for effective sharing of information but is a potential source for errors. The e-handover was initially audited and a standard operating procedure (SOP) was subsequently produced by a multi-professional team of allied health professionals, nursing and medical staff and the ward pharmacy team. This SOP was introduced in August 2017 with the intention to ensure accuracy and a consistent approach in sharing of information. Re-audit in September 2017 showed significant improvements in all domains and this further re-audit in September 2018 aimed to assess if these improvements had been sustained.
Methods 17 patients’ notes and e-handovers were audited by two independent members of the MDT against standards developed by The Academy of Medical Colleges, local nursing guidelines and against palliative care outcome measures. Results were then directly compared to earlier audits in 2017.
Results One hundred percent of patients had an accurate primary diagnosis on their handover and all documented in the correct place. 66% of patients had a documented preferred place of death (PPD), 100% had a documented and accurate escalation status (ES), 71% had a documented phase of illness (PoI) and 82% had Australian Karnofsky performance status (AKPS) documented. 32% of handovers were easy to read and 92% used trust approved acronyms. This confirmed deterioration in some domains, particularly PPD, PoI and AKPS, all of which were recorded as 100% in September 2017.
Conclusion One year after implementation of the SOP there has been deterioration in some of the information on the e-handover. Further work is needed to identify factors involved, such as changeover of staff, and to then re-educate ward staff in the completion of the handover.
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