Event Review: Safer Handover Action Update

The Safer Handover programme aims to investigate how patients and information used by clinicians involved in providing their care is communicated through the system, with an initial focus on interactions between primary and secondary care.

In May 2017, the Safer Handover team brought together frontline clinical staff, allied healthcare professionals, management executives, administrators and commissioners from primary and secondary care to create a multi-disciplinary team. Delegates participated in an intense three day rapid improvement event. Six months later, this team has expanded and re-grouped to review progress and participate in focused task-based workshops.

Dr Jeremy Tankel (Medical Director and Clinical Lead for Quality and Safety, Salford CCG) provided an overview of the background, sharing a compelling, but familiar, example how information is not properly communicated at the point of handover and the implications for the patient.

Workshops:

Participants were then divided into three groups and given an opportunity to feedback progress on actions since the last session to the leadership team: Francine Thorpe (Director of Quality and Innovation, Salford CCG), Dr Pete Turkington (Medical Director, Salford Royal NHS Foundation Trust) and Dr Jeremy Tankel. The trio were equally keen to celebrate achievements and learn about the challenges faced over the intervening six months. Some key themes were identified and taken away for the leaders to consider over the afternoon.

Reflecting the quick-fire nature of the event, participants were immediately split into their workshop groups to focus on tackling a specific problem surfaced at the previous event.

One of the things we received positive feedback on at the previous event was the value in bringing together individuals from across settings to solve problems:

“I don’t think we always realise the impact of our actions on the next clinician managing the patient – this makes us think differently about who we are communicating to, and why

This spirit of collaboration and sharing was evident during the first workshop session and discussions carried on through as participants took the opportunity to share and network during the ‘afternoon tea’ break:

Moving into workshop session two, participants were able to either continue important conversations or focus their expertise on a new problem. Many of those unable to attend the initial event were able to offer unique and valuable insight to help identify potential causes of failure and rationalise our actions to gain greater impact from efforts to date.

Task management system

Understanding and developing solutions to enable GP practices to manage tasks will have an impact on the efficiency and ability to ensure actions transferred between settings are completed. This double workshop looked at:

  • Reviewed survey of task management in general practice in Salford to surface variation
  • Identified duplication and time inefficiencies in using different task management systems to communicate and transfer information (with some practices using 10+ different systems!)

eCheck-in

  • To improve patient flow when attending outpatient appointments, this workshop was tasked with developing a series of tests of change and measures, with a focus on patient experience and time / efficiency savings

Discharge summary

Much of the activity relating to transfer of care from secondary to primary care focused on the quality of discharge summaries. The purpose of this double workshop was to unpick these actions and identify a clear process to make improvements:

  • Improve the quality of information inputted at the start of the patient journey, and develop infrastructure to automatically feed this throughwhen a patient is ready to be discharged
  • Identify some “must do” small edits to the existing discharge summary
  • Review the quality and format of information provided to patients
  • Develop measures to learn from discharge summaries, to support and co-ordinate audit to have a focus on integration and improvement

Follow up test protocols

An issue which frequently raises concerns as patients are transferred from secondary care is where the responsibility for completing any required follow up tests lies.

Optimising patient pathways

With coaching support from Abigail Harrison (Director of Innovation, Haelo) a small group were tasked to develop an aim, potential measures and a change idea leading to the development of a new innovation project bid (watch this space!):

  • Increase understanding of processes during a patient journey
  • Reduce duplication by optimising the pathway between primary and secondary care

Leadership actions:

Once all the teams had provided feedback on progress during the workshop sessions, Dr Pete Turkington reflected back on some of the things he had heard throughout the afternoon, with a particular eye to tackling the challenges reported. One of the key issues highlighted is the overlap with other related initiatives and unpicking the complexity of co-ordinating our efforts.

Closing:

Finally, Francine Thorpe thanked everyone for their time and enthusiasm today, recognising the need to continue to harness the energy and commitment so the Safer Handover programme can deliver real improvements to clinician experience and patient safety.

If you think your work links to Safer Handover? If you would like to hear more about the programme, contact us.

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