Download PDFPDF

Making the weekend work: a local quality improvement project to establish and improve the quality of weekend handover
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g.
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests


  • Responses are moderated before posting and publication is at the absolute discretion of BMJ, however they are not peer-reviewed
  • Once published, you will not have the right to remove or edit your response. Removal or editing of responses is at BMJ's absolute discretion
  • If patients could recognise themselves, or anyone else could recognise a patient from your description, please obtain the patient's written consent to publication and send them to the editorial office before submitting your response [Patient consent forms]
  • By submitting this response you are agreeing to our full [Response terms and requirements]

Vertical Tabs

Other responses

Jump to comment:

  • Published on:
    A further patient safety addition to the structured handover tool
    • Joanna L Bovis, Core Surgical Trainee Chelsea and Westminster Hospital
    • Other Contributors:
      • Luthfur Rahman, Orthopaedic Registrar
      • Tim Sinnett, Orthopaedic Consultant

    Dear Sir,

    Your recently published article by Heller and Hu looking at improving the weekend handover system in their hospital is interesting and thought provoking. They found that they improved the standard of the written handover between weekday and weekend teams by introducing a structured intranet-based handover tool.1

    A similar project was recently undertaken at our Orthopaedic Department. Our methodology and reasons for undertaking the quality improvement project were similar.

    One part of our intervention was different however, and I wonder if the study’s authors would be interested in incorporating it into their excellent handover tool?

    We too developed a handover tool, albeit not as sophisticated as the author’s intranet based tool. We redesigned our Microsoft Word document to be more user friendly, comprehensive and fulfil standards from the BMA and RCS.2,3 Our key addition was that of traffic light colour-coding of patients. We used colours to assign patients to levels of clinical input needed over the weekend.

    This served to address one of the most daunting part of the weekend on call, identifying who are the most vulnerable patients.

    Patients are assigned to one of three colours, red, amber or green. Red patients are day one post operative or unstable patients, perhaps septic or with difficult to manage fluid balances. Amber patients are stable patients with a higher possibility of becoming unstable, those recently c...

    Show More
    Conflict of Interest:
    None declared.