Audit of Handover Practice

We compliment Bhabra and colleagues on a well thought-out study that highlights the issue of handover, which is becoming more relevant to the surgical community with the implementation of shift patterns of working. Their experiment demonstrated the varying reliability of handover methods and the possible loss of data which could compromise patient care. Their evidence that a pre-printed sheet of patient data almost entirely eliminates data loss is compelling. This method, however, is time consuming and would require doctors to access a computer terminal several times during a busy shift. At our institution, a recent audit of handover practice demonstrated an issue of poor data transfer between shifts. We designed standardised handover sheets, with fields for the required patient identifiers and clinical data. These sheets were located in clinical areas and completed by hand during shifts. Re-audit after implementation found that data transfer improved from 50.2% to 78.3%, and the proportion of injuries without a recorded side fell from 42% to 11%. Our sheets are practical, inexpensive, portable, and readily accessible to be updated during shifts and we believe this to be a good alternative to computerised handover.