BT35 Quality improvement project: modernizing the inpatient dermatology handover

Abstract Dermatology is unique in our region because it provides on-call services to multiple sites and different National Health Service (NHS) trusts locally. This presents a number of challenges as different NHS trusts utilize different information technology and procedural systems. This quality improvement project (QIP) aimed to find a solution to the problem of having an effective and efficient handover system for inpatients across different trusts. Prior to this QIP, the handover consisted of an email that was sent at the end of each day summarizing the inpatient cohort. This had several issues including missing details, delayed updates and not updating all of the relevant staff. The initial Plan Do Study Act (PDSA) cycle surveyed the clinical staff to assess whether there was a problem with the current handover and potential solutions that could be considered. The results showed that the team were dissatisfied with the current handover and the majority utilized the on-call service to find out about the inpatients. Of the available solutions, the majority of staff wanted to explore an online solution via Microsoft Teams. The main challenge with the proposed handover on Teams was maintaining patient confidentiality given the sensitivity of the data being held. This was reviewed with the clinical governance team and a data protection impact assessment was carried out and approved. A Teams group and handover file were then created. The feedback highlighted that the handover template needed optimization, resulting in a second PDSA cycle. Senior colleagues approved a suitable template that was then trialled on the Teams group for handover. The survey results showed a significant improvement in the content, accessibility, usability and means of handover. The main issue identified was that some staff did not know how to access the Teams group to view the handover. This was remedied with the creation of a standard operating procedure, which provided instructions on how to access and use the new handover. This QIP with two PDSA cycles provided a number of advantages such as the ability of the handover to be accessible to a predefined group of people from any site or trust, and that it can be updated in real time. It can also be utilized and updated during virtual board rounds. Most importantly, this change has created an effective and efficient means of handover, as is reflected in the results of the postintervention survey.