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. 2018 Aug;93(8):1234-1244.
doi: 10.1097/ACM.0000000000002236.

Educational Interventions to Improve Handover in Health Care: An Updated Systematic Review

Morris Gordon  1 , Elaine Hill, Jennifer N Stojan, Michelle Daniel
Affiliations

Educational Interventions to Improve Handover in Health Care: An Updated Systematic Review

Morris Gordon et al. Acad Med. 2018 Aug.

Abstract

Purpose: Effective handovers (handoffs) are vital to patient safety. Medical educators investigated educational interventions to improve handovers in a 2011 systematic review. The number of publications on handover education has increased since then, so authors undertook this updated review.

Method: The authors considered studies involving educational interventions to improve handover amongst undergraduate or postgraduate health professionals in acute care settings. In September 2016, two authors independently conducted a standardized search of online databases and completed a data extraction and quality assessment of the articles included. They conducted a content analysis of and extracted key themes from the interventions described.

Results: Eighteen reports met the inclusion criteria. All but two were based in the United States. Interventions most commonly involved single-patient exercises based on simulation and role-play. Many studies mentioned multiprofessional education or practice, but interventions occurred largely in single-professional contexts. Analysis of interventions revealed three major themes: facilitating information management, reducing the potential for errors, and improving confidence. The majority of studies assessed Kirkpatrick's outcomes of satisfaction and knowledge/skill improvement (Levels 1 and 2). The strength of conclusions was generally weak.

Conclusions: Despite increased interest in and publications on handover, the quality of published research remains poor. Inadequate reporting of interventions, especially as they relate to educational theory, pedagogy, curricula, and resource requirements, continues to impede replication. Weaknesses in methodologies, length of follow-up, and scope of outcomes evaluation (Kirkpatrick levels) persist. Future work to address these issues, and to consider the role of multiprofessional and multiple-patient handovers, is vital.

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Figures

Figure 1
Figure 1
Flow diagram showing inclusion and exclusion of articles for a literature review of studies (published between January 2011 and September 2016) on teaching handover.
Figure 2
Figure 2
Instructional methods for teaching patient handover in health care, as extracted from studies published between January 2011 and September 2016.
Figure 3
Figure 3
Instructional content for teaching patient handover in health care as extracted from studies published between January 2011 and September 2016.
See this image and copyright information in PMC

References

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    1. World Health Organization Collaborating Centre for Patient Safety Solutions. Communication during patient hand-overs. Patient safety solutions. http://www.who.int/patientsafety/solutions/patientsafety/PS-Solution3.pdf. Published 2007. Accessed March 3, 2018.

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