NSW Safe Clinical Handover Program Presenter: James Dunne

1. Innovation Poster Session HRT1215 – Innovation Awards Sydney 11th and 12th Oct 2012 NSW Safe Clinical Handover ProgramPresenter: James Dunne Agency for Clinical Innovation 1-1c_HRT1215-Session_DUNNE_ACI_NSW

2. KEY PROBLEM Poor patient handover contributes to adverse patient outcomes Root Cause Analysis data The Special Commission of Inquiry (Garling) Australian Commission on Safety and Quality in Health Care – National Clinical Handover Initiative World Health Organisation – one of WHO’s top 5 priorities Between the Flags – Recognition and management of the deteriorating patient MJA supplement, “Clinical Handover : Critical Information” – supplement of 14 papers published on 1st June 2009

3. AIM OF THIS INNOVATION To implement standard key principles for clinical handover across the care continuum Acute Care Taskforce Standard key principles + flexible standardisation = System level change Standard Key Principles

4. BASELINE DATA Some key scenarios were clearly identified as high risk for safe patient handover, following review of RCA and IIMS data: • Escalation of deteriorating patients • High acuity to low acuity transfer (e.g. ICU to ward or recovery unit to ward) • Junior to senior clinicians (particularly between medical teams) • Inter-facility transfer • Community and General Practice to hospital • Hospital to community and General Practice • Transfer of mental health patients • Emergency Department to ward • Multidisciplinary team handover • Nursing / midwife shift to shift handover

5. KEY CHANGES IMPLEMENTED Standard Key Principles • Leadership • Valuing handover • Handover participants • Handover time • Handover place • Handover process

6. NEXT STEPS

7. OUTCOMES SO FAR All Area Health Services (now LHDs) + Children’s Hospital at Westmead, Justice Health and the Ambulance Service of NSW (Health Services) have submitted an implementation plan for Safe Clinical Handover. All Health Services have hosted an implementation monitoring site visit with members of the Acute Care Taskforce. Bedside nursing and midwifery handover strategy is consistently being implemented in organisations. Taped handover is being eradicated from all Health Services Significant energy and strategy are ensuring engagement of medical teams in clinical handover improvement. 85% at the facility level agreed / strongly agreed that ‘The statewide Safe Clinical Handover Program has assisted our department/unit to implement and/or improve our clinical handover process’1 1Clinical Excellence Commission Quality Systems Assessment (2010)

8. LESSONS LEARNT Principle based approach Flexible standardisiation Distilling the work of many Sponsorship Leverage from other changes in the system Sharing our work www.archi.net.au