Effective handover is crucial for ensuring the safe transition of patient care between medical teams. Despite its importance, handover remains a high-risk area for medical errors globally, ranking among the top priorities for the World Health Organization. The Trauma and Orthopedics (T&O) department at Morriston Hospital faced challenges with a paper-based handover system, utilized by orthopedic, spinal, and orthogeriatric teams when transferring weekend responsibilities to ward cover Senior House Officers (SHOs). This method was associated with a notable increase in clinical incidents and complaints.

An audit of all weekend handover sheets from September 2022 was conducted, assessing compliance against the minimum standards outlined by the Royal College of Surgeons of England (RCSE) for Safe Handover. Additionally, electronic surveys were administered to gather the perspectives of T&O SHOs on the existing weekend handover system. The surveys aimed to explore the feasibility of a new intervention using the Microsoft OneDrive system available in the health board.

The audit revealed an overall poor compliance rate with RCSE guidelines (0% for Orthopedics, 70% for Orthogeriatrics, and 90% for Spinal). Surveys indicated that 100% of SHOs considered the handwritten handover unsafe, and unanimously expressed a preference for utilizing Microsoft OneDrive. The Quality Improvement Project (QIP) introducing the virtual handover system was implemented in October 2022. This initiative led to a significant reduction in reported Datixs, dropping from 4 incidents in September 2022 to none.

Transitioning to a paperless handover system, utilizing the available electronic infrastructure within the local health system, proves to be a cost-effective and efficient solution for ensuring a safe handover process within the Trauma and Orthopedics department. The successful implementation of Microsoft OneDrive demonstrated improved compliance, reduced incidents, and enhanced overall patient care within the department.