The ‘SAFE PT’ Handover: A Qualitative Study for Developing an Improvised Tool Facilitating Safe Patient Handover

Abstract

Objectives: The aim of this study is to identify and establish an effective and a standardized tool that is easily reproducible for the safe handover of patients at end of shift at the emergency department (ED) for continuity of care, smooth transition and minimising errors. This tool is designed to assist emergency physician and nurses in building a safe patient culture one that is reliable and upholds the standards of quality and improvement guided by international goals. Methods: To develop this tool; the end users were consulted for understanding the requirements through group discussion, interviews and surveys involving emergency physicians and nurses of different grades. This was further augmented by reviewing literature on international accepted tools. Based on the above information gathered; a tool was developed which was simple, practical and included all necessary details of the patient in an easy and structured format. Results: Group discussions, interviews and survey conducted showed that current handover practice needed improvement and there was inadequate information being passed on between shifts. This was of concern to most participants and they felt that absence of a reliable tool led to unsafe handovers. The need of the hour was a reliable tool which would standardize and smoothen the handover of patients between shifts in a safe manner. Participants cited examples of leak of information in the current practice which would have changed their approach to patient and having a direct impact on the quality of care delivered. There was also varied responses regarding what was a safe handover practice and prior training received on handover process and the contents of a good handover were found lacking. In order to standardize the handover process based on internationally acclaimed approach and specific to needs as received by end users of the ED, the SAFE PT tool was developed incorporating the relevant details of patient care to facilitate the smooth and safe continuity of care between shifts. Conclusions: Clinical handover is a high-risk area for patient safety and quality in health care and therefore of high priority for the ED. The SAFE PT tool was derived to emphasize on a culture of patient safety and also for easy recollection of the desired information to be included for a quicker and safer continuity of care between shifts in the ED leading to improved patient satisfaction. ISSN: 2474-3674 DOI: 10.23937/2474-3674/1510082 Mikky et al. Int J Crit Care Emerg Med 2019, 5:082 • Page 2 of 10 • • Patient centred care • Patient care planning • Patient care team • Quality of health care • Inter-professional relations • Safety • Handover • Shift change • Clinical information transfer • Handover practice • Shift handover • Tools and handover • Bedside handover • Shift briefings • Shift report • End of shift reports • Shift change reports • Handover practices • Patient handover • Team handoffs Inclusion criteria All literature included in the review had the following characteristics. The paper was: • Published not earlier than 1995 • Written in English • Related to the search terms • Based on either qualitative or quantitative data • A review, research paper or report, guideline, or case study that describes the relationship between handover or communication between shift variables and patient or customer outcomes.