SP 6.03 Improving Surgical Handover Report Documentation: A Three-Cycle Audit
Leon Liu, Christophe ThomasAbstract
Aims
To evaluate the completeness and timeliness of general surgery handover report documentation used for weekend on-call cover. To assess whether an induction-embedded intervention improved compliance with national handover standards.
Methods
A prospective three-cycle audit assessed handover reports for all general surgery inpatients across three wards prior to weekend on-call cover. Variables assessed included patient inclusion on the handover list, whether entries were updated prior to handover, and documentation completeness in line with Royal College of Surgeons of England guidance on safe handover. Following the initial audit cycle, results were disseminated departmentally, after which a structured handover tutorial was embedded into resident doctor induction. Compliance with audit standards was then compared across cycles.
Results
Across 304 patients, patient inclusion in the handover list rose from 42% at baseline to 89%, and the proportion of entries updated prior to handover rose from 27% to 77%. Documentation completeness in line with guidance increased from 23% to 50%; however, omissions in patient status and outstanding investigations persisted. These gains were most marked in the acute admission ward and among on-call teams and were sustained despite resident doctor turnover.
Conclusions
Embedding handover expectations into resident doctor induction was associated with sustained improvements in handover list inclusion and update frequency, despite staff turnover. Documentation completeness plateaued at 50%, indicating that while human-factor interventions improve consistency of handover report updates, further gains are likely to require system-level solutions such as electronic handover templates.