135 A quality improvement project (QiP) to improve handover between settings

<h3>Background</h3> Clear handover is key to ensure patient safety and continuity of care. Evidence suggests handover between care settings at the end of life is associated with lower symptom crises and unplanned hospitalisations.¹ Our specialist palliative care (SPC) team received a complaint concerning patient between settings and therefore we decided to implement a QiP to improve handover between settings. <h3>Methods</h3> We sought background from stakeholders. We surveyed GPs and community palliative care teams (CPCT) on how they currently receive handover. We surveyed local hospital SPC teams to see their practice. We consulted a lay steering group member for a patient’s perspective. We then decided we would write a SPC section on the hospital discharge summary, and produced a crib sheet to highlight what information should be included. <h3>Results</h3> From surveying community stakeholders we found they felt handover to be inconsistent, and sometimes no information was received. 100% thought they would find it helpful to have information on the discharge summary. 50% of local SPC teams wrote on the hospital discharge summary as handover. Within our SPC in April 2024 only 1% of the discharge summaries had any SPC input, this has risen to 42% in September. <h3>Conclusions</h3> We hope that having SPC input into the discharge summary has increased flow of information from hospital to community settings, to ensure continuity of care for patients. We plan to re-survey GPs and local CPCT to get their perspective on this handover method, as well as go through further PDSA cycles within our team to increase the number of discharge summaries we have added to. <h3>Reference</h3> den Herder-van der Eerden M, Hasselaar J, Payne S, et al. How continuity of care is experienced within the context of integrated palliative care: A qualitative study with patients and family caregivers in five European countries. <i>Palliative Medicine</i> 2017;<b>31</b>(10):946–955. doi:10.1177/0269216317697898