Salisbury NHS Foundation Trust has, with financial support from Skills for Health - Workforce Projects Team (WPT), over the past two years developed an IT solution to improve the quality and structure of handover within the Hospital at Night (HaN) model of care.
The development of this system is a key component of the achievement of EWTD compliance. A risk assessment of the previous handover arrangements identified serious issues such as:
Breakdown in communications because of poor verbal and written information
Poor levels of attendance at handover meetings leading to an inability to audit the process
Patients handed over in a rushed and informal manner
Information governance and data protection being compromised. The project, which was lead by the trust’s medical director, has resulted in:
A simple, generic and multiprofessional system supporting verbal handover which can be implemented by any trust with a HaN process in place (or in trusts currently implementing HaN)
Two integrated IT solutions which were designed by clinicians for clinicians - Consultant List for daytime use and HaN List for out of hours use
The development of attendance registers resulting in an almost 100% increase in specialty team attendance at handovers
The involvement of multiprofessional staff in handover activities leading to crucial and relevant information being shared 24/7
No increase in HaN attributed adverse events despite an increased frequency of handovers
The development of training packages to support staff in using the IT solutions.
The Consultant List enables each user to create a consultant or ward based list of patients which will contain the demographics, management plan and outstanding actions. The list can be accessed 24/7 and multiprofessional users can flag a patient onto the HaN system.
The HaN List is used by the team to manage any ‘at risk/unstable’ patients out of hours. The list contains the reason for referral to HaN, the management plan and timeliness of review. The list can be printed off for use by the HaN team and is used to support the discussions at the handover meetings.
The auditable and password protected system is web based and links to the trusts PAS system. The system has been designed for transferability to other NHS trusts and is supported by means of a ‘train the trainer’ package and an e-learning module.
The IT system has been demonstrated at a number of events and conferences including the National Patient Safety Conference held in Birmingham at the end of March 2009.
Salisbury NHS Foundation Trust and WPT will be making this IT system software available to twenty NHS trusts in the near future. Training and support will also be provided.
Trusts interested in installing the system should contact Debbie Dupont, project manager at Salisbury NHS Foundation Trust: debbie.dupont@salisbury.nhs.uk
or visit: www.healthcareworkforce.nhs.uk/salisbury
Working Time Directive 2009 
