Naxakis Stelios, Wafer Megan, Gardezi Syeda, Sadia Aamina, Mujahid Rimsha, O'Connor Karen
Psychiatry, University College Cork, Cork, Ireland
University College Cork, Cork, Ireland.
BMJ Open Qual. 2025 Jan 6;14(1):e002978. doi: 10.1136/bmjoq-2024-002978.
Cork University Hospital, Ireland's largest teaching hospital, faced challenges in maintaining consistent handover processes in its Acute Mental Health Unit (AMHU). Prior to 2019, handovers relied on informal methods, risking information loss and compromising patient care. This quality improvement (QI) initiative aimed to standardise handover practices using an electronic tool integrated with the ISBAR communication protocol.
The project aimed to ensure accurate clinical information recording, improve patient care and safety, centralise handover material, enhance clinical transparency and accountability, and measure handover quality using the electronic tool.
Using a Plan-Do-Study-Act (PDSA) model, the initiative began with a critical incident in July 2020, prompting the creation and piloting of an electronic 'handover tool' aligned with ISBAR. Subsequent PDSA cycles included mandatory policy implementation and educational interventions to reinforce tool usage and adherence to communication standards.
The electronic handover tool improved handover practices, with increased compliance to recommended criteria and enhanced tool utilisation. Notable improvements followed targeted educational interventions, leading to more comprehensive and standardised handover entries. These improvements enhanced communication and information transfer among NCHDs, contributing to better continuity of care and patient safety.
The QI initiative successfully standardised handover processes and improved communication among NCHDs in the AMHU. While improvements were observed, ongoing efforts are needed to address challenges and sustain effectiveness. Continuous training, feedback mechanisms and further refinement of the handover tool are essential for long-term success. Future directions include exploring additional technological solutions and reinforcing a culture of effective communication.
爱尔兰最大的教学医院科克大学医院在其急性精神科病房（AMHU）维持一致的交接班流程方面面临挑战。2019年之前，交接班依赖非正式方法，存在信息丢失风险并危及患者护理。这项质量改进（QI）举措旨在使用与ISBAR沟通协议集成的电子工具来规范交接班实践。
该项目旨在确保准确记录临床信息，改善患者护理和安全，集中交接班材料，提高临床透明度和问责制，并使用电子工具衡量交接班质量。
该举措采用计划-实施-研究-改进（PDSA）模型，始于2020年7月的一起重大事件，促使创建并试用了与ISBAR一致的电子“交接班工具”。随后的PDSA循环包括强制实施政策和教育干预措施，以加强工具使用并确保遵守沟通标准。
电子交接班工具改善了交接班实践，对推荐标准的依从性提高，工具利用率增强。有针对性的教育干预措施带来了显著改善，使交接班记录更加全面和标准化。这些改进加强了非顾问医生（NCHDs）之间的沟通和信息传递，有助于更好地实现护理连续性和患者安全。
这项QI举措成功规范了AMHU的交接班流程，并改善了NCHDs之间的沟通。虽然取得了改进，但仍需持续努力应对挑战并维持有效性。持续培训、反馈机制以及进一步完善交接班工具对于长期成功至关重要。未来的方向包括探索更多技术解决方案并强化有效沟通的文化。
