A quality improvement project to improve handover in the integrated assessment liaison team

BACKGROUND: Efficient handovers are integral to patient care. Challenges to handover for liaison psychiatry included high patient and staff turnover and varied handover approaches across the multidisciplinary team (MDT). METHOD: MDT focus groups and questionnaires explored change ideas. PDSA cycles were used to design a structured handover. We aimed to: Reduce handover time to 30 minutes. Improve communication using the SBAR tool. Implement a multidisciplinary teaching schedule in the time saved. Daily measures: Handover timing Team Satisfaction (Individuals ranked handover as ‘good’, ‘average’, or ‘poor’) Weekly measures: Semi-qualitative questionnaires triangulated areas for improvement. Emails, posters and team meetings provided team feedback regarding QI progress. RESULT: A structured twice-daily handover format incorporating SBAR, allocated handover coordinators and documentation was created. Weekly MDT teaching sessions were developed. Over 4 weeks, ‘good’ handover ratings increased from 22% to 65%; ‘poor’ ratings decreased from 25% to 8%. Mean handover time decreased from 37 minutes to 28.5. The team viewed SBAR as a positive efficiency-promoting tool. MDT teaching improved team communication and confidence. Documentation is an area to improve. CONCLUSION: Structured handover has promoted efficiency and effective information-sharing amongst the liaison psychiatry team. Interdisciplinary teaching can promote inclusive team feeling and encourage confidence across the MDT.