title: Standardised proformas improve patient handover: Audit of trauma handover practice.
abstract: BACKGROUND
  The implementation of the European Working Time Directive has meant the introduction of shift patterns of working for junior doctors. Patient handover between shifts has become a necessary part of practice in order to reduce the risk of medical errors. Data handed over between shifts are used to prioritise clinical jobs outstanding, and to create theatre lists. We present a closed-loop audit of handover practice to assess whether standardised proformas improve clinical data transfer between shifts during handover in our Orthopaedic Unit.
  
  
  METHODS
  We collected data handed over between shifts for a period of one week at our department. The data were in the form of hand written data on plain paper used to assist verbal handover. Data were analysed and a standardised handover sheet was trialled. After feedback from juniors the sheet was revised and implemented. A re-audit, of handover data, was then undertaken using the revised standardised proforma during a period of 1 week.
  
  
  RESULTS
  Forty-eight patients were handed over in week 1 while 55 patients were handed over during re-audit. The standardised proformas encouraged use of pre-printed patient labels which contained legible patient identifiers, use of labels increased from 72.9% to 93.4%. Handover of outstanding jobs increased from 31.25% to 100%. Overall data handed over increased from 72.6% to 93.2%. Handover of relevant blood results showed little improvement from 18.8% to 20.7%
  
  
  CONCLUSIONS
  This audit highlights the issue of data transfer between shifts. Standardised proformas encourage filling of relevant fields and increases the data transferred between shifts thereby reducing the potential for clinical error cause by shift patterns.
authors.affiliation: Department of Trauma and Orthopaedics, University Hospital of Wales, Cardiff, UK. nferran@uku.co.uk.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Ferran
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Metcalfe
authors.forename: Declan
authors.initials: D
authors.lastname: O'Doherty