Improving Patient Safety through Multi-Disciplinary Handover of High Risk Antenatal Women
Swansea Bay University Health Board
Introduction:
At Singleton Hospital, Swansea Bay, a lack of documented handover between the antenatal and labour ward teams was flagged by Healthcare Inspectorate Wales (HIW) as a significant risk to patient safety, care quality, and service efficiency. Audit findings confirmed 0% compliance with antenatal handover documentation, prompting the need for urgent improvement to ensure safe, effective, and coordinated care for high-risk antenatal patients.
Methods:
Using a structured quality improvement (QI) approach guided by the Model for Improvement, the team collected staff feedback via surveys and analysed themes around poor compliance. Tools such as driver diagrams, Pareto charts, and stakeholder analysis were used to understand key issues and inform solutions. A series of Plan-Do-Study-Act (PDSA) cycles tested interventions including staff education, redesigning the handover form, and targeting communication to weekend staff to drive improvement.
Outcomes:
Documented handovers increased from 0 to 6 per week, with significant shifts following each PDSA cycle. Improvements enhanced patient safety through more reliable communication, ensured continuity of care for complex cases, and improved staff accountability and teamwork. The project was commended during a follow-up HIW visit. Benefits extended to the wider system through better governance, reduced duplication, and fewer delays.
Learnings:
Success stemmed from involving the right people early, using data to guide and motivate change, and embedding small, iterative adjustments. Team collaboration, visible leadership, and consistent reinforcement proved essential. Staff engagement grew when solutions were co-designed, and barriers reduced. Balancing measures confirmed no harm or delays were introduced.
What next?
Plans include improving weekend handover compliance, embedding training into staff induction, exploring digital handover solutions, and encouraging a wider culture of continuous improvement through further QI projects.
