Effective Project Handovers for QI Trainee Rotation Changes

Why this topic matters

Quality Improvement is an iterative process, often requiring sustained effort over time to embed changes and measure their impact. For trainees, who regularly change placements, maintaining this continuity is a common hurdle. Without a structured handover, progress can be lost, and successor teams may have to re-invest time understanding the project, or worse, abandon it entirely.

Effective handovers are critical for:

• Sustainability of improvement: Ensuring that positive changes become embedded and do not revert.
• Efficiency: Preventing duplication of effort and wasted resources.
• Learning and development: Allowing new team members to pick up a project mid-flight provides a valuable learning opportunity.
• Trainee recognition: Ensuring previous work is acknowledged and integrated into the ongoing project, which can be vital for portfolio evidence.
• Patient safety and experience: Sustained QI contributes directly to better patient care.

Practical explanation: What constitutes a good QI handover?

A good QI handover is more than just a quick chat and a few notes. It's a structured transfer of knowledge, ongoing tasks, and future plans to a successor, ensuring they have all the necessary information and support to take ownership and continue the work effectively. It involves documenting the project's journey, current status, and next steps, along with clearly identifying key stakeholders and resources.

It’s important to distinguish QI projects from clinical audit for portfolio purposes. While both can be valuable, QI often involves implementing and testing changes, whereas audit typically measures against standards. Local governance and ARCP guidance should always be followed for classification.

Common pitfalls

Several issues can undermine a QI project handover:

• Lack of dedicated time: Handover is often rushed due to clinical pressures and rotation deadlines.
• Poor documentation: Incomplete or disorganised project records make it hard for a new person to understand the context.
• Lack of identified successor: No one is assigned to take over, or the person identified is not adequately prepared.
• Reliance on informal communication: Verbal handovers are prone to omissions and misinterpretations.
• Absence of project sponsorship: Without senior leadership or QI team oversight, projects can lose momentum easily.
• Unclear roles and responsibilities: The outgoing and incoming project leads may not understand what is expected of them.
• Focus purely on past progress: Neglecting to clearly outline 'next steps' and 'what needs to be done'.

Step-by-step approach for a successful QI project handover

1. Plan for handover early

Start thinking about handover logistics at least 4-6 weeks before rotation. Identify a potential successor or the QI lead/consultant who will temporarily oversee the project.

2. Document everything comprehensively

Create a dedicated QI project handover document. This should not be a separate report, but ideally a compilation or clear summary of existing project documentation. Include:

• Project Title and Aim: Clearly state the project's purpose using a SMART or PICO-like format.
• Background/Rationale: Briefly explain 'why' the project was needed, referencing any initial data or problem statements.
• Methodology: Outline the QI model used (e.g., PDSA cycles), data collection methods, and tools.
• Progress to date: Summarise key interventions, PDSA cycles completed, and their outcomes. Include run charts or control charts.
• Key Findings/Results: What has been learned? What impact has been observed?
• Current Status: Is the project ongoing, paused, or awaiting feedback? What is the very next task to be done?
• Next Steps/Future Plans: Detail planned further PDSA cycles, data collection, analysis, or dissemination. Be specific about actions.
• Stakeholders: List all key individuals involved (sponsors, team members, data custodians, clinical leads) with their contact details and roles.
• Resources: Location of data, templates, software, previous presentations, or relevant policies.
• Obstacles/Challenges: Highlight any known issues or potential barriers.
• Learning/Reflections: What advice would you give to the next person?

3. Identify and engage a successor

Work with your supervisor and the QI lead to identify who will take over. Ideally, this is another trainee or a member of the permanent team. Introduce them to the project and provide initial guidance.

4. Schedule a dedicated handover meeting

This meeting should include yourself, your successor, and ideally, your supervisor or the QI lead. Allow ample time (e.g., 60-90 minutes) for a thorough discussion. Review the handover document together, clarify any points, and answer questions.

5. Provide access to project files

Ensure all relevant documents, data, and communication logs are accessible in a shared, secure location (e.g., shared drive, dedicated QI platform).

6. Introduce successor to key stakeholders

Where appropriate, facilitate introductions to core project team members, data custodians, and senior stakeholders. A brief email introduction can also be helpful.

7. Agree on a checking-in schedule (optional but recommended)

If possible, agree to be available for a limited period (e.g., 2-4 weeks after rotation) for questions, or define how the successor can access ongoing support from the QI team.

8. QI Lead/Supervisor Oversight

For QI leads and supervisors, actively participate in steps 1, 3, and 4. Your presence ensures accountability and provides continuity beyond individual trainees. Maintain a central register of ongoing QI projects within your department or trust.

Example in clinical practice

Dr. Anya Sharma, a Foundation Year 2 doctor, is leading a QI project on improving the rate of venous thromboembolism (VTE) risk assessment completion in the surgical receiving unit. Her rotation ends in 6 weeks. She has completed two PDSA cycles, showing an increase in assessment rates from 60% to 85% post-intervention. She now needs to embed these changes and monitor for sustainability over a longer period.

Her handover process:

1. Early Planning: Dr. Sharma discusses her rotation with her consultant and the departmental QI lead. They agree the project is critical for patient safety and must continue.
2. Successor Identification: The QI lead identifies Dr. Ben Carter, a new F2 joining the team, as a suitable successor. Dr. Sharma proactively reaches out to Dr. Carter.
3. Documentation: Dr. Sharma updates her project documentation, ensuring all run charts are current, the PDSA cycles are clearly summarised, and the project aim and metrics are explicit. She creates a 'Handover Summary' document detailing the current VTE assessment rate, the next two planned data collection points, and a list of key stakeholders (surgical registrar, ward manager, pharmacy).
4. Handover Meeting: A 90-minute meeting is scheduled with Dr. Sharma, Dr. Carter, and the consultant. They review the project's history, current status, the data, and crucially, discuss the next steps: setting up a reminder system for new junior doctors, and presenting findings at the next departmental meeting.
5. Access and Introductions: Dr. Sharma ensures Dr. Carter has access to the shared drive where all project files are stored. She introduces Dr. Carter to the ward manager and surgical registrar.
6. Follow-up: The consultant schedules a follow-up meeting with Dr. Carter in 4 weeks to check on progress.

This structured approach ensures that Dr. Sharma's valuable work isn't lost, and Dr. Carter can seamlessly continue the project, gaining valuable QI experience in the process.

How Lazomis can help

Lazomis provides a structured framework for managing QI projects, which inherently facilitates robust handovers.

• Centralised Project Repository: All project documentation, including aims, methods, data, and PDSA cycle summaries, can be stored in a single, accessible platform. This eliminates the 'searching for files' common pitfall.
• Clear Project Status & Next Steps: Lazomis allows for clear designation of project status, overdue tasks, and upcoming milestones, making it easy for a new project lead to understand where the project stands and what needs to be done.
• Team Collaboration Features: Easily add new team members (successors) to a project and transfer ownership. They gain immediate access to all project history and associated discussions.
• Reporting & Visualisation: Dashboards and automated run charts ensure that the project's progress and impact are clearly visible and up-to-date, providing an instant snapshot for the incoming lead.

By leveraging Lazomis, teams can establish a consistent, standardised approach to QI project management that inherently supports successful handovers, improving project continuity and sustainability across rotation changes.

Key takeaways