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Journal Article > Review
The effects of patient handoff characteristics on subsequent care: a systematic review and areas for future research.
Foster S, Manser T. Acad Med. 2012;87:1105-1124.
Reforms that limited duty hours for resident physicians stimulated efforts to enhance the safety of patient handoffs, and innovative approaches to improving safety have drawn on methods from other industries (including automobile racing). However, this systematic review of nursing and physician handoffs found little high-quality research on the effectiveness of specific handoff methods. Although use of standardized handoff sheets appeared to improve the quality of handoffs, the authors were unable to find evidence linking any handoff interventions to better patient outcomes. A case of poor handoff communication that led to an avoidable surgical procedure is discussed in this AHRQ WebM&M commentary.
Journal Article > Study
"It's like two worlds apart": an analysis of vulnerable patient handover practices at discharge from hospital.
Groene RO, Orrego C, Suñol R, Barach P, Groene O. BMJ Qual Saf. 2012;21:i67-i75.
Despite the well-documented prevalence of adverse events after hospital discharge and a growing policy focus on preventing readmissions, the factors leading to poor care transitions are not well understood. This qualitative study from Spain used in-depth interviews with patients, hospital staff, and primary care providers to better define the mechanisms by which adverse events and readmissions occur. The investigators found that discharge processes are often haphazard and a major source of frustration for hospital providers, and that patients often shoulder the burden of communicating clinical information to their primary care providers, which leaves those with limited health literacy particularly vulnerable to errors. These findings mirror and expand upon prior research. This study is part of a large, multi-national effort to improve the quality of patient handovers.
Journal Article > Study
Estryn-Behar MR, Milanini-Magny G, Chaumon E, et al. J Patient Saf. 2014;10:29-44.
This direct observation study found that registered nurses, physicians, and nursing aides have frequent interruptions and limited time for shift-change handoffs. This finding suggests that widespread efforts to ensure adequate handoff time and minimize interruptions have not mitigated these problems in hospital settings.