AB127. SOH23ABS_091. Pilot study to develop a pre-operative “cardiothoracic clinical handover tool” and its effect on handover quality

Background: Clinical handover is an essential step in the surgical patient’s hospital journey but one that is not without risk. Within cardiothoracic surgery, endeavours to protocolise post-operative handover from cardiac theatre to cardiac intensive care units have resulted in enhanced patient safety, but little to no effort has focused on the pre-operative setting and the dissemination of information throughout the surgical team.

Methods: Thus, we designed a pre-post study examining the quality of pre-operative cardiothoracic patient handovers before and after the introduction of an intra-departmentally designed “Cardiothoracic Clinical Handover Tool” based on the Royal College of Surgeons of England’s guidelines for “Safe Handover”.

Results: In total, 80 clinical handovers were assessed, with 40 in each arm of the study. Handover quality significantly improved from a score of 63.75% to 88.57% (P<0.001). This prolonged handover duration from a mean of 72.1 to 102.4 seconds per case (P=0.003). Interruptions occurred in 27.5% of pre- and 25% of post-intervention handovers. Interruptions resulted in increased handover durations overall (114.6 vs. 77.7 s, P=0.012), poorer quality handovers in the pre-intervention group (51.28% vs. 68.42%, P=0.03) but failed to impact quality following the introduction of the handover tool (88.57% in both groups, P=1).

Conclusions: We conclude that clinical handover tools have the potential to significantly enhance the quality of pre-operative handover and protect against poor handover practices, such as interruptions, thus safe-guarding patient welfare. We provide the first cardiothoracic specific pre-operative handover tool for adaptation to meet local requirements in other centres.

Keywords: Cardiac surgery; clinical handover; quality improvement; thoracic surgery; tools