From Zero to Sixty: Revving Up Driving Safety Documentation

Background: After an acute hospitalisation, driving limitations have significant medicolegal and safety ramifications.  The need for improved driving guidance throughout the region was brought to light by recent community events.

Methods: We used a PDSA cycle and informal focus groups to structure our project. Before and after a straightforward intervention consisting of clinician education and structured advice layouts, we examined the records of fifty patients. Documenting of driving status and giving suitable driving advice were the outcomes measured.  We gathered data and developed materials to help clinicians give advice.

Results: Documentation of driving status significantly improved from 12% to 60% (p < 0.000001) after the first intervention cycle. In the same time, provision of driving advice increased from 3.9% to 44.4% (p = 0.0017). Interpretation is influenced by confounders: the post-intervention group had longer length of stay, younger patients were less likely to be assessed by the teams who were documenting driving status regularly, and documentation varied by staff role and specialty. Occupational therapists, neurology and cardiology clinicians documented most consistently; most advice was given by experienced medical registrars.

Conclusion: A low-cost intervention significantly improved documentation and advice-giving. Variation by staff group highlights clear targets for future education and standardisation.