Shift-to-Shift Handoff Effects on Patient Safety and Outcomes

Abstract

Multiple health care organizations have identified handoffs as a source of clinical errors; however, few studies have linked handoff interventions to improved patient outcomes. This systematic review of English-language research articles, published January 2008 to May 2015 and focusing on shift-to-shift handoff interventions and patient outcomes, yielded 10 774 unique articles. Twenty-one articles met inclusion criteria, measuring each of the following: patient falls (n = 7), reportable events (n = 6), length of stay (n = 4), mortality (n = 4), code calls (n = 4), medication errors (n = 4), medical errors (n = 3), procedural complications (n = 2), pressure ulcers (n = 2), weekend discharges (n = 2), and nosocomial infections (n = 2). One study each also measured time to first intervention, restraint use, overnight transfusions, and out-of-hours deteriorations. Studies that reported funding had higher quality scores. It is difficult to identify trends in the handoff research because of simultaneous implementation of multiple interventions and heterogeneity of the interventions, outcomes measured, and settings. The authors call for increased handoff research funding, especially for studies that include patient outcome measures.

Nursing handovers and patient safety: Findings from an umbrella review

“…As emerged from the quality assessment of the included reviews, most checklist items were satisfied as reported in Table S2. According to the findings, an effective handover promotes better patient outcomes (Mardis et al, , ; Sherman, Sand‐Jecklin, & Johnson, ) and has great importance for PS (Buus et al, ) especially in postoperative care (Møller et al, ) and in the intensive care unit where patients are vulnerable because of their complex clinical history and the critical nature of their conditions (Colvin et al, ). NHs are also important as a system to guarantee professional support (e.g., Holly & Poletick, ; Matic et al, ) and continuity of care (e.g., Buus et al, ; Smeulers et al, ) where barriers affecting the quality of communication can have multiple consequence, both on PS and professionals (e.g., Halm, ; Riesenberg et al, ).…”

“…In all, 16 reviews have reported suggestions for future research (Table ) highlighting this field as a priority (Colvin et al, ) as well as stressing the need to increase funding for handover studies, especially those measuring patient outcomes (Mardis et al, ). Among the research lines suggested, reviews highlighted the need to develop studies aimed at detecting the best method to provide reliable and valid data (Matic et al, ), along with the effectiveness of standardized handovers (Colvin et al, ; Mardis et al, ).…”

“…The reviews also revealed a set of outcomes that should be scrutinised in future studies that were divided into three main domains: (a) patients’ outcomes such as falls, pressure sores, and length of stay (e.g., Mardis et al, ); (b) handover process outcomes regarding the implementation itself (e.g., compliance; Smeulers et al, ), and (c) the implications for nurses as a result of the implementation process (e.g., work overtime; Sherman et al, ).…”

“…Due to their relevance, NHs have become an international priority in both the research and clinical fields (Tobiano, Bucknall, Sladdin, Whitty, & Chaboyer, ). As a consequence, several primary studies have been performed and later summarized in reviews highlighting research and practical recommendations (e.g., Mardis et al, ; Staggers & Blaz, ). However, no summary of the established recommendations from the available reviews has been produced to date as an accessible and practical document (Ortega, Lopez‐Briz, & Fraga‐Fuentes, ).…”

Clinical Handover among Physicians: A Survey in a North Eastern Italian Academic Hospital

“…To transfer essential information and responsibility for patient care from one health care provider to another (a practice commonly referred as handover) is an integral component of communication in healthcare setting (ACSQHC, 2005;Ong & Coiera, 2011;Mardis et al, 2015). Clinical handover is the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person or professional group on a temporary or permanent basis (ACSQHC, 2009;ACSQHC, 2011).…”