SRS53 - An optimised surgical handover system improves patient physiology: findings from the sips prospective cohort study

Abstract Background Ineffective handover leads to patient harm, yet no gold standard exists for safe and effective practice in surgery. The aim of this study was to determine whether a novel surgical handover system would lead to improved patient physiology and safety. Methods A prospective interventional cohort study was carried out in the general surgery departments of two tertiary academic hospitals. Doctors participating in handover were trained in the use of a four-step approach to handover meetings (SIPS), which defines the minimum steps required for safe surgical handover. Handover quality, patient outcomes, and staff perceptions of safety were evaluated through handover observations, a review of patient records, and staff surveys. Patients were eligible for inclusion if they had a minimum of six hours of Early Warning Score(EWS) data available following the handover meeting. Results A total of 126 handover meetings were observed, data were collected for 2267 patients, and 182 NCHDs took part in handovers during the study. Post-intervention, handover quality improved (P < 0.001) without prolonging meeting duration, and was associated with significant improvements in patient vital signs (demonstrated by lower EWS) at 12 h (21.5 versus 16.8%, P = 0.007) and 24 h (26.8 versus 20.0%, P < 0.001). Staff-reported handover-related patient safety events decreased post-intervention (4.6 versus 19.7%; P = 0.004). Conclusions The SIPS surgical handover system was associated with improvements in handover quality, patient physiology, and staff perceptions of safety, without prolonging handover meetings. These findings provide support for SIPS as an effective method of reducing risks to patients from surgical handover.