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

2. The Health Roundtable 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 2

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

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. The Health Roundtable KEY CHANGES IMPLEMENTED Standard Key Principles 1.Leadership 2.Valuing handover 3.Handover participants 4.Handover time 5.Handover place 6.Handover process 5

6. The Health Roundtable NEXT STEPS 6

7. The Health Roundtable 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 1 Clinical Excellence Commission Quality Systems Assessment (2010) 7

8. The Health Roundtable 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 8