A strategic solution to preventing the harm associated with ambulance handover delays
Intended for healthcare professionals
Evidence and practice    

A strategic solution to preventing the harm associated with ambulance handover delays

Cliff Evans Nurse consultant/educationalist, emergency department, Medway NHS Foundation Trust, Gillingham, Kent, England
Adebayo Da’Costa Clinical director, acute and emergency medicine, Medway NHS Foundation Trust, Gillingham, Kent, England

Why you should read this article:
  • To recognise that overcrowded emergency departments result in ambulance handover delays causing avoidable harm to patients awaiting assessment

  • To identify how forward planning and anticipatory escalation processes can reduce the potential for patients to experience avoidable harm

  • To learn how a strategic quality improvement project improved patient safety and the working lives of front-line healthcare professionals

Ambulance handover delays arise when emergency departments become overcrowded as patients waiting prolonged periods for admission occupy clinical cubicles designed to facilitate the assessment and treatment of emergency arrivals. In response, many organisations become reliant on temporarily lodging acutely unwell patients awaiting admission in undesignated areas for care such as corridors, to provide additional space. This results in a significant risk of avoidable harm, indignity and psychological trauma for patients and has a negative effect on the well-being of healthcare professionals, since unacceptable standards of care become normalised. A two-phase strategic quality improvement project was implemented at the authors’ acute trust. Ambulance handover data from between 2 November 2020 and 26 July 2021 provided a benchmark for the project. The first phase was implemented between 2 November 2021 and 26 July 2022 and aimed to reduce 60-minute ambulance handover delays.

The second phase was implemented between 2 November 2022 and 26 July 2023 and aimed to eradicate 60-minute ambulance handover delays and improve overall performance. Phase one resulted in a 32% reduction in 60-minute ambulance handover delays. Phase two resulted in a 97% reduction in 60-minute ambulance handover delays. Over the course of the project there was a 24% increase in handovers completed within 15 minutes. This project demonstrates how strategic planning and collaboration between healthcare teams can reduce the potential for avoidable patient harm, while simultaneously promoting workforce well-being and retention.

Emergency Nurse. doi: 10.7748/en.2024.e2199

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

Correspondence

cliffevans@nhs.net

Conflict of interest

None declared

Evans C, Da’Costa A (2024) A strategic solution to preventing the harm associated with ambulance handover delays. Emergency Nurse. doi: 10.7748/en.2024.e2199

Published online: 30 April 2024

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