7Effective handover communication: An overview of research and improvement efforts
Section snippets
Patient handover as a priority of patient safety research
Patient care is an inherently communicative activity. It is therefore not surprising that communication issues are among the most frequent contributory factors of adverse events identified in retrospective adverse-event analyses4, 5, 6 and that several observational studies highlight the frequency and negative consequences of communication breakdowns.7, 8, 9
Communication processes are particularly vulnerable at organisational interfaces, such as care transitions and shift changes. The
What is the current handover practice?
Studies describing handover practice show significant variation within and across health-care settings. Despite these variations, four phases have been identified in patient handover in clinical settings: pre-handover, arrival, handover meeting and post-handover.25, 26Especially for handovers of multiple patients at a time, it has been shown that pre-handover preparation – one of the safety-critical handover strategies identified in high-reliability organisations15 – is often insufficient.22, 27
Moving handover research and improvement efforts forward
Based on this overview, two areas in handover research emerge that deserve an accentuated focus in the future: (1) improved research designs to overcome current methodological problems and (2) broadening the understanding of patient handover to a team task and not just a one-way transfer of information.
Conclusions
There is wide agreement that patient handover is a key process to improve patient safety, and that formal systems for patient handover combined with formal training on effective handover communication will promote patient safety in all areas of health-care.1, 16, 17, 90
It has been pointed out that human factors’ research is integral to interdisciplinary research aimed at understanding and improving patient handover.90 The contribution of human factors’ science in supporting current research and
Conflict of interest
None.
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