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- Amy Maher, Henry Hsu, EbrahimMohamed Eftal Bin MohamedMEBMGoulburn Base Hospital, Goulburn, Australia., Matthew Vukasovic, and Andrew Coggins.
- University of Sydney Clinical School, Westmead Hospital, Sydney, New South Wales, Australia.
- J Eval Clin Pract. 2024 Oct 30.
ObjectiveIncreasing complexity in healthcare systems necessitates effective handover. While a universal structure is often recommended, many frameworks do not include the patient. A systematic review was completed examining outcomes following handover that included patients or carers using a realist-orientated paradigm.MethodsThe research group used Covidence™ software and followed PRISMA guidelines. A librarian-led search of Embase, Medline, PsycINFO and SCOPUS yielded 5,790 relevant studies for screening. Included studies reported on peer-reviewed studies that assessed qualitative or quantitative outcomes resulting from patient-centred handover. To assess quality, we used the McMaster Mixed Methods Appraisal Tool (MMAT). Patient-orientated and quantitative outcomes are reported descriptively. For qualitative outcomes, we employed a deductive analytical approach. Braun and Clarke's steps were followed to develop themes with group work used to clarify and discuss the various codes. Heterogenous reporting precluded meta-analysis.ResultsThirty studies were eligible (10 mixed methods; 11 quantitative; 9 qualitative) with variable quality and scope. Most studies related to nursing-led bedside handover and originated in Anglophone countries. Positive effects were reported for patient satisfaction, engagement, autonomy and effective information exchange. Providers reported a positive experience but also barriers to implementation, cognitive load and reducing compliance over time. There were contradicting findings for patient-orientated outcomes including falls risk. Publication bias may have led to under reporting of negative trials. There was limited reporting on physician-led handovers that included patients.ConclusionsPatient-centred handover was associated with self-reported benefits for patients and providers but potential advantages over conventional handover could be undermined by barriers such as time, implementation challenges and a perceived increase in staff workload.© 2024 John Wiley & Sons Ltd.
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