Surgical handover in a Sri Lankan setting: problems, pitfalls and prevention of error

Abstract

INTRODUCTION:Effective clinical handover ensures continuity of patient care. There is little evidence regarding clinical handovers in the Sri Lankan setting assesses the effect of standardised pro-forma on clinical data transfer among team members during a surgical casualty. MATERIAL AND METHODS: We collected data handed over from admission during a surgical causality,for a period of 12 weeks to the university surgical unit of Colombo North Teaching Hospital(CNTH), where clinical handovers are consultant-led, conference-based and carried out with an educational focus. Initial stage, clinical handovers were carried out using a verbal method. A standardised pro-forma was trialled according to the recommendations in literature. After revaluation the sheet was revised and implemented. A re-audit of handover data, was then undertaken using the revised standardised pro-forma during the last 6 weeks. RESULTS: Total of 223 patients handed over verbally and 256 using standardized pro-forma. The only incident of delay in treatment attributed to handover process occurred during verbal handover (p=0.94648967). Incidents causing investigation delays occurred once during pro-forma based over and thrice during verbal handover (p=0.83231572). Two incidents of prolongation of hospital stay occurred during verbal method compared to one during pro-forma based method (p=0.88203094). DISCUSSION AND CONCLUSIONS: Though' the results are not statistically significant, we feel the use of standardised pro-forma could be valuable as a sentinel tool to avoid catastrophic events. The standardised pro-forma is now an accepted and important part of patient management in the university surgical unit of CNTH.