Effective communication is central to promoting patient safety and reducing the number of serious clinical incidents. CNST (Clinical Negligence Scheme for Trusts) Maternity Standard 4-criterion 8 requires a maternity service has approved documentation describing the process for ensuring there is an effective system for handover of care onsite between healthcare professionals involved in women's care that is implemented and monitored.
The CHAPs (Clinical picture, History, Assessment and Plan) handover tool is adapted from the American SBAR (Situation, Background, Assessment and Recommendations) tool and has been gaining popularity in UK maternity units. In our unit, midwives have used the CHAPs handover tool on the Labour Ward for over 12 months. Handover of care occurs in the presence of the women, time spent on handover has reduced, and the number of clinical incidents has fallen. This tool is now being used in other areas where handover of care occurs, such as triage and antenatal day assessment unit.
It became apparent that a structured handover tool was needed to make medical staff handovers safer and more efficient. A written tool based on the CHAPs model was developed. Following feedback from registrars and consultants minor changes were made and, after ratification at the Labour Ward Forum, the tool was introduced into clinical practice. Twice daily (08:30 and 20:30), the care of at-risk obstetric and gynaecological women, including all outliers, is handed over following a structured consistent pathway. Documentation and verbal communication have improved and regular audit monitors compliance.
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