Table 1

Summary of literature

Article (first author)MethodologyFindings and conclusions
Gandhi3Case study of errorsMultiple handoffs can lead to diffused responsibility, necessitating clear lines of responsibility
Vidyarthi4Case and commentaryDiscontinuity in hospitals is inevitable, especially with shifts. “Sign-out” should be standardised
Horn5Survey of UK anaesthesia handover practiceLittle formalisation, differing opinions on key considerations. Guidelines, standardisation and documentation would help
Kerr6Observation and interviews of nurse handover—sociotechnical perspectiveHandover is complex, with social and educational aspects
Manias7Ethnographic study of nursing handoverIdentified practices within handover, including tyranny of busyness, tyranny of tidiness and need to identify sense of finality
Lally8Observational studyTeam building was a stronger theme than transfer of patient information during nursing handover
Sherlock9Observational studyHandover is complex, with variable quality of information, lack of organisation and standardisation. Teaching and documentation are required
Skeoch10CommentaryIssues raised in handover of neonates from transport
Sexton11Audio-taping of nursing handovers84.6% of information discussed could be found elsewhere. Streamlining could improve quality and reduce time
Thakore12Questionnaires for those involved in handover of patients from ambulance to resuscitationIdentified a need for training to improve quality
Patterson13Observation study to identify strategies for handover in different industriesDifferent strategies used in different industries have different consequences for failure
Leonard14CommentaryThere is a need to standardise communication in clinical practice
Bomba15Observation, questionnaire and interviewsDoctors' handover was unstructured, informal and error prone. Formalisation and computerisation would help
Nemeth16Observation and conversation analysisExpertise depends on the ability to prioritise information; formal training in handover may benefit patients and clinicians
Coiera17Observation in emergency departmentThere is a need for training in communication. Interruptions disrupt memory processes. Most information exchanges are informal
Alvarez18Observation in intensive care unitThere is a high burden of interruptions on communications in the intensive care context
Berens19ReviewNoise levels in the paediatric intensive care unit are sufficiently high to be of concern
Barenfanger20Interventional behavioural study in laboratory contextIntroducing “readback” into communication procedures reduces errors
Australian Council for Safety and Quality in Healthcare21Review on system, organisational culture and individual factors influencing handoverThere is a need for protocols and training in handover
Solet22Observational study of four different junior doctor handoversFour major barriers to an effective hand-off were (1) physical setting, (2) social setting, (3) language barriers and (4) communication barriers. Precise, unambiguous, face-to-face communication is best. Standardisation and education are required
Hopkinson23Phenomenological study (semistructured interviews)Handover is a forum for expressing opinions and feelings as well as patient information
Strange24Ethnographic observational studyRitual of handover serves valuable psychological, social and protective functions
Odell25Review of communication theory applied to nursing shift handoverHandover should be constantly reviewed to maintain efficiency. Theory can help develop staff and the handover process
Anwari26Observation to develop a scale to assess quality of handoverScale incorporated quality of verbal information, patient condition, professional behaviour and nurse's satisfaction with handover
McKenna27Description of process for changeHandover times were successfully reduced, allowing more efficient working
Kelly28Questionnaires+description of process for changeChanging handover location can be achieved by careful management
Watkins29Description of process for changeChanging handover location can be achieved by careful management
Williams30Description of process for changeChanging handover location can be achieved by careful management
Miller31Review articleRegular reviews, written guidelines and preprepared handover sheets help maintain efficiency
O'Connell32Observational study+semistructured interviews (five nursing acute care setting handovers)No particular style was superior. Handover helps to debrief, clarify and educate
Kennedy33Observational study+interviewsNursing care plans can replace oral handovers and are more efficient
Wallum34Description of process for changeNursing care plans can replace oral handovers
Meißner35Questionnaire surveyHandover frequently causes irritation, often due to organisational problems
Borowitz36Prospective questionnaire surveyImportant information is often missed
McCann37Questionnaire surveyClinical problems were attributed to poor handover. Set location, standardised handover sheet and training were recommended
Ye38Observational study+questionnaire surveyImportant information is often missed, leading to adverse effects. Standardisation, use of IT, feedback, quality assurance and education were suggested
Bhabra39Observational studyPrinted handout sheets improved retention of information
Catchpole40Observational studyIntroduction of handover protocol (based on motorsport/aviation) reduced technical errors, omissions and handover time
Fenton41AuditUse of a handover guide may improve structure and information content
Ferran42AuditUse of a proforma increased quantity of information transferred
Pothier43Observational studyPrinted handout sheets improved retention of information
Wayne44Observational study, focus group discussion+various surveysSimplification and standardisation of handoff instrument led to increased accuracy, completeness and reduced tasks transferred
Talbot45Observational studyStructuring verbal handover did not improve information retention by receiving staff
Singh46Study of closed malpractice claimsHandoff problems are associated with medical errors involving trainees
Wilson47Technical reportA clinical handover appliance can support safe handover
Hertzum48Questionnaire study, observational study+interviewsUse of an electronic patient record increased clarity about work tasks and reduced omissions at handover
Wong49Case studyEnd-users must be involved in the development of electronic support tools for handover
Chaboyer50Quality improvement project (location change, practice guideline and competency standard)Quality improvement agenda for handover improves safety, efficiency, teamwork and senior support
Kassean51Description of process for changeChanging handover location can be achieved by careful management
Wilson52ReviewAssessing feasibility of IT tools for improving handover
Bruce53Experience reporting, qualitative interviewsDifficult or “non-ideal” handovers characterised by complicated care situation