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Medical handover . TAPS – Training and Action for Patients Safety. C. Ruprai , M. Kotlinska , C. Brewer, A. Wilson, Mrs. Jha. What is TAPS?. New training programme ↓ Helping multi-professional clinical teams ↓ Develop innovative solutions ↓
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Medical handover.TAPS – Training and Action for Patients Safety. C. Ruprai, M. Kotlinska, C. Brewer, A. Wilson, Mrs.Jha
What is TAPS? New training programme ↓ Helping multi-professional clinical teams ↓ Develop innovative solutions ↓ Address common patient safety problems
TAPS programme • Designed by Bradford Institute for Health Research and panel of active clinicians • Running across Yorkshire (inc. Bradford, Leeds, Sheffield, Doncaster, York) • 10 teams in Hull (inc. Acute Medicine, Orthopaedics, Pharmacy) • O&G team: C. Ruprai, M. Kotlinska, C. Brewer, A. Wilson, Mrs. Jha
Medical handover Poor handover has repeatedly been implicated as a causative factor in adverse incidents & improvement in handover has been advocated by a number of agencies
Challenges EWTD Increase patient load Frequent movement of patients Involvement of multiple specialist team Corridor or inconvenient meeting room Type, formality & information varies Interruptions
TAPS 20 week programme November 2011 – March 2012 4 workshops ↓ 1st staff survey (Nov. 2011) Results presented at Joined Obs.&Anaest. Meeting ↓ Handover audit (presented in PNM Dec. 2011) ↓
TAPS ↓ Introduction of unified handover sheet (Jan. 2012) ↓ Weekly audits for 10 weeks ↓ 2nd staff survey
Your perception of handover • 2 staff surveys (November 2011 and March 2012) • The questionnaire was randomly given to different levels of staff • 46 participants in first one and 33 in the second one • Obstetric, midwifery and anaesthetic members of staff
Results • Perception of O&G consultant presence at the handover 74% • Evident absence of the anaesthetic staff • 70% - appropriate setting of the handover • Average score for quality of the handover across all staff was 3.6 (scale 1-5)
Who is consistently present at handover 1st survey 2nd survey
Overall quality of handover Overall3.6 Overall 3.8
Is there consistent handover between O&G SpR and consultant between 5-7pm
Conclusion • Excellent morning handover involving whole MDT • Clear improvement in many areas of the handover in TAPS process • Audit once a year is not good enough tool in monitoring change and hence should be undertaken more frequently
Recommendations • Evening face-face communication between obs. SpR and consultant needs to be improved, already has been communicated to senior staff • Repeat staff survey in next several months • Share the experience with others (our ‘journey’ may be used to help improve medical handover in other clinical areas)