Northern Ireland general surgery handover study: Surgical trainees' assessment of current practice

Introduction: Effective handover of clinical information between work shifts is essential for patient safety. We aimed to identify current practice and trainees' assessment of handover in the general surgical departments of Northern Ireland (NI). Methods: A postal questionnaire was sent to 90 general surgical trainees (BST and HST) currently working in acute hospitals in NI. Information regarding timing, location, duration, participation and quality of handover was collated anonymously. Trainees commented on satisfaction with current practice and its perceived safety. Results: 62 questionnaires were returned (69%), 36 by SHOs and 26 by registrars. Forty-nine percent reported that handover took place with more than one grade of doctor present. Two percent reported that handover was bleep free. Eight (13%) had received formal training on good handover. Thirty-four (55%) were working in a unit that operated a ‘surgeon of the week’ system of emergency cover. Satisfaction was recorded on a four point Likert scale. (0=very dissatisfied with handover 3=very satisfied) Overall satisfaction level was 1.57 out of 3. Those working in ‘surgeon of the week’ teams had significantly higher scores (1.82 versus 1.31 [p<0.05]). Overall, 47% of trainees believed that current handover practice was adequate to ensure patient safety (56% in ‘surgeon of week’ group and 37% in the remaining group, [p<0.05]). Conclusion: General surgical trainees in NI have expressed concern regarding current practices of patient handover between shifts. Those working under the ‘surgeon of the week’ emergency system are more satisfied and deem it significantly safer.