Patient perceptions of outcomes used to evaluate in-hospital handover interventions: a rapid review of qualitative data

Abstract

Objectives: High quality handover is critical for patient safety and care continuity. Existing practice is based on a weak evidence base in which the patient voice is poorly captured. The aim of this study was to identify outcomes of importance to patients, families and carers regarding interventions to improve in-hospital handover between healthcare practitioners.

Design: A rapid systematic review of qualitative literature was carried out after prospective registration with PROSPERO and was reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines.

Data sources: The Ovid MEDLINE database was searched.

Eligibility criteria: Qualitative or mixed-methods studies reporting patient, family or caregiver perspectives on in-hospital handovers were eligible for inclusion.

Data extraction and synthesis: Synthesis was informed by the best-fit framework approach using a published taxonomy of handover-related outcomes and the Core Outcome Measures in Effectiveness Trials taxonomy. Outcomes were reported according to two distinct types of handover: bedside (patient-involved) and provider-focused (patient-uninvolved).

Results: A total of 34 studies, including 1262 participants across a range of specialties and predominantly high-income settings, were analysed. 53 bedside and 31 provider-focused handover outcomes were identified according to four domains; adverse events, quality of patient care, quality of handover and patient/caregiver satisfaction. Bedside handover studies frequently reported outcomes relating to patient engagement and communication with healthcare staff. One study was carried out in a low income country; however, outcomes identified were broadly similar.

Conclusions: These findings expand the known outcomes for evaluating handover interventions and highlight the importance of prioritising the patient and public perspective in research. This work will contribute to developing a core outcome set for trials in surgical handover but can also be applied to handover practices for any other discipline within the hospital environment.

Prospero registration number: CRD42023493367.

Keywords: Methods; Patient Participation; Patient Reported Outcome Measures; Patient Satisfaction; QUALITATIVE RESEARCH; STATISTICS & RESEARCH METHODS.

Figure 1. PRISMA flow diagram. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses. From Page et al.