Background Out-of-hour handover enables continuity of care and its failure can lead to preventable patient harm and inefficiencies. At our hospital, handover for weekend medical ward cover takes place on a Friday afternoon and patients requiring review are uploaded to a secure electronic system. A baseline audit identified poor attendance, inadequate information and inappropriate task allocation as major issues resulting in difficulty prioritising tasks and focusing clinical reviews over the weekend.

Methods The following interventions were implemented over 6 weeks: (1) Restructuring of handover into three staggered timeslots allocated to each floor of the hospital; (2) A ‘Handover Guide’ was circulated with handover information including ‘dos and don’ts’; (3) Any patient added to the electronic system after 5pm was verbally handed over to the on-call Medical team and (4) Weekly reminder emails and WhatsApp messages are circulated and poorly attending wards highlighted. Over 4 consecutive weekends, data on attendance, number of patients handed over and handover contents were collected and evaluated.

Results There was an overall improvement in attendance by the on-call and ward teams. The total number of patients handed over was 73 patients per weekend (76 at baseline). The proportion of patients added to the electronic system after handover reduced from a 16–68% increase at baseline to 0–16% post-intervention. There was an overall reduction in the number of investigations being handed over and a small increase in clinical reviews.

Conclusion Due to the 24-hour service provided by the NHS, face-to-face handover is critical to help ensure patient safety and optimal outcomes are achieved. Effective structuring and peer-education of an effective handover system can improve the quality of handover and enable better and safer patient care.