Improving Nursing Handovers in a Voluntary Mental Health Facility

Around the globe, ineffective handovers have resulted in grave consequences, leading to handover improvement strategies being introduced, along with guidelines being

formulated in many countries. Despite this, however, few studies focused on improving handovers in a psychiatric setting. This current Quality Improvement Project aims to

fill this gap and improve nursing handovers in a mental health facility by 50% over eight months. Using Lean Six Sigma's, Define Measure Analyse Improve Control framework and various quality improvement tools, the current handover process of the institution was analysed, showing that the handover summary sheet was not updated and the handovers were not documented. By observing 20 handovers against a designed checklist, a baseline median handover observation score of 4.8 was established, which corresponded to 32% of an ideal handover. A staff survey was also conducted to evaluate staff opinion regarding current handovers. Root cause analysis showed a lack of handover protocol as a modifiable cause. From the literature review and the data analysis, implementation of a HAND ME AN ISOBAR handover communication template, incorporating the minimum data needed for the ward, was suggested as a practical solution using Plan- Do- Study -Act cycles. To monitor and sustain the improvements, periodic post-intervention handover audits using the designed checklist, and then comparing it with the baseline measurements, was advised. The success of the project will help the institution’s nursing handover to be up to date, relevant, and accurate and to also comply with the National Clinical Guidelines recommendation of standardisation of handovers.