Abstract
BACKGROUND: Effective clinical handover is essential for continuity and patient safety, particularly during weekends when staffing levels are reduced. Incomplete or unclear handovers contribute to delays, missed investigations, and preventable errors. This quality improvement project aimed to enhance the quality and reliability of weekend handovers on a respiratory ward in a UK District General Hospital. METHODS: Over an eight-week period, the project employed two Plan-Do-Study-Act cycles to assess and improve handover practices. Baseline data from 44 weekend handovers were audited for completeness of blood test requests, antibiotic prescriptions, and discharge documentation. A structured weekend continuity checklist was then introduced, prompting weekday teams to document key patient information before the weekend. Post-intervention data were collected from 50 weekend handovers and compared using chi-square or Fisher's exact tests. RESULTS: Baseline data revealed deficiencies in blood test handovers (20%, 9/44 incomplete), antibiotic coverage (11%, 4/38 missed), and discharge summaries (55%, 6/11 incomplete). Following implementation of the checklist, missed blood test handovers decreased to 2% (1/50, p = 0.024), antibiotic lapses reduced to 4% (2/48, p = 0.469), and all discharge summaries were completed (100%, p = 0.038). Venous thromboembolism assessments and escalation plans were documented for all patients post-intervention, reflecting improved preparedness and communication. CONCLUSION: Introducing a structured weekend handover checklist significantly improved handover completeness, documentation quality, and clinical preparedness for weekend teams. This low-cost, sustainable tool reduced process-related errors and enhanced patient safety and continuity of care. The findings support wider adoption of standardized handover protocols to strengthen weekend care delivery across hospital settings.