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Going the extra mile — cross-border patient handover in a European border region: qualitative study of healthcare professionals’ perspectives
  1. Juliëtte A Beuken1,
  2. Daniëlle M L Verstegen1,
  3. Diana H J M Dolmans1,
  4. Laura Van Kersbergen2,
  5. Xavier Losfeld3,
  6. Saša Sopka2,4,
  7. Lina Vogt2,4,
  8. Mara E J Bouwmans1
  1. 1 Educational Research and Development / School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
  2. 2 Interdisciplinary Training Center of Medical Education and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany
  3. 3 Level 1 Trauma Center, Emergency Department, CHR Citadelle, Liege, Belgium
  4. 4 Department of Anesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
  1. Correspondence to Ms Juliëtte A Beuken, School of Health Professions Education, Maastricht University, Maastricht, Please select an option below, Netherlands; j.beuken{at}


Background Cross-border healthcare is complex, increasingly frequent and causes potential risks for patient safety. In this context, cross-border handovers or the transfer of patients from one country to another deserves particular attention. Although general handover has been the topic of extensive research, little is known about the challenges of handover across national borders, especially as perceived by stakeholders. In this study, we aimed to gain insight into healthcare professionals’ perspectives on cross-border handover and ways to support this.

Methods We conducted semistructured interviews with healthcare professionals (physicians, nurses, paramedics and administrative staff) in a European border region to investigate their perspectives on cross-border handover. The interviews were aimed to investigate settings of acute and planned handover. Informed by the theory of planned behaviour (TPB), interviews focused on participant perspectives. We summarised all interviews and inductively identified healthcare professionals’ perspectives. We used elements of the TPB as sensitising concepts.

Results Forty-three healthcare professionals participated. Although respondents had neutral to positive attitudes, they often did not know very well what was expected of them or what influence they could have on improving cross-border handover. Challenges covered five themes: information transfer, language barriers, task division and education, policy and financial structures and cultural differences. To overcome these challenges, we proposed strategies such as providing tools and protocols, discussing and formalising collaboration, and organising opportunities to meet and get to know each other.

Conclusion Healthcare professionals involved in cross-border handovers face specific challenges. It is necessary to take measures to come to a shared understanding while paying special attention to the above-mentioned challenges. Meeting in person around meaningful activities (eg, training and case discussions) can facilitate sharing ideas and community building.

  • patient safety
  • qualitative research
  • teamwork
  • communication
  • hand-off

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  • Funding This study was funded by European INTERREG V-A programme and the regional province (cofinancing).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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