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. 2024 Mar 1;8(2):zrae011.
doi: 10.1093/bjsopen/zrae011.

Daily handover in surgery: systematic review and a novel taxonomy of interventions and outcomes

Jessica M Ryan  1   2   3 , Fiachra McHugh  4 , Anastasija Simiceva  1 , Walter Eppich  1 , Dara O Kavanagh  5   6 , Deborah A McNamara  7   8   9
Affiliations

Daily handover in surgery: systematic review and a novel taxonomy of interventions and outcomes

Jessica M Ryan et al. BJS Open. .

Abstract

Background: Poor-quality handovers lead to adverse outcomes for patients; however, there is a lack of evidence to support safe surgical handovers. This systematic review aims to summarize the interventions available to improve end-of-shift surgical handover. A novel taxonomy of interventions and outcomes and a modified quality assessment tool are also described.

Methods: Ovid MEDLINE®, PubMed, Embase, and Cochrane databases were searched for articles up to April 2023. Comparative studies describing interventions for daily in-hospital surgical handovers between doctors were included. Studies were grouped according to their interventions and outcomes.

Results: In total, 6139 citations were retrieved, and 41 studies met the inclusion criteria. The total patient sample sizes in the control and intervention groups were 11 946 and 11 563 patients, respectively. Most studies were pre-/post-intervention cohort studies (92.7%), and most (73.2%) represented level V evidence. The mean quality assessment score was 53.4% (17.1). A taxonomy of handover interventions and outcomes was developed, with interventions including handover tools, process standardization measures, staff education, and the use of mnemonics. More than 25% of studies used a document as the only intervention. Overall, 55 discrete outcomes were assessed in four categories including process (n = 27), staff (n = 14), patient (n = 12) and system-level (n = 2) outcomes. Significant improvements were seen in 51.8%, 78.5%, 58.3% (n = 9761 versus 9312 patients) and 100% of these outcomes, respectively.

Conclusions: Most publications demonstrate that good-quality surgical handover improves outcomes and many interventions appear to be effective; however, studies are methodologically heterogeneous. These novel taxonomies and quality assessment tool will help standardize future studies.

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Figures

Fig. 1
Fig. 1
PRISMA flow diagram
Fig. 2
Fig. 2
Handover intervention and outcome taxonomy (continued overleaf)
Fig. 2
Fig. 2
Handover intervention and outcome taxonomy (continued overleaf)
See this image and copyright information in PMC

References

    1. CRICO Strategies . Malpractice risk in communication failures; 2015 Annual Benchmarking Report. Boston, MA: The Risk Management Foundation of the Harvard Medical Institutions, Inc. Feb 10, 2016. https://psnet.ahrq.gov/issue/malpractice-risks-communication-failures-20... (registration required for download) (accessed 6 January 2023)
    1. Wilson RM, Runciman WB, Gibberd RW, Harrison BT, Newby L, Hamilton JD. The quality in Australian health care study. Med J Australia 1995;163:458–471 - PubMed
    1. Agarwal R, Sands DZ, Schneider JD, Smaltz DH. Quantifying the economic impact of communication inefficiencies in US hospitals. J Healthcare Manage 2010;55:265–282 - PubMed
    1. Cohen MD, Hilligoss PB. The published literature on handoffs in hospitals: deficiencies identified in an extensive review. Qual Saf Health Care 2010;19:493–497 - PubMed
    1. Bigham MT, Logsdon TR, Manicone PE, Landrigan CP, Hayes LW, Randall KH et al. Decreasing handoff-related care failures in children's hospitals. Pediatrics 2014;134:e572–e579 - PubMed

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