BMJ quality & safety
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BMJ quality & safety · Dec 2012
Multicenter StudyThe key actor: a qualitative study of patient participation in the handover process in Europe.
Patient safety experts have postulated that increasing patient participation in communications during patient handovers will improve the quality of patient transitions, and that this may reduce hospital readmissions. Choosing strategies that enhance patient safety through improved handovers requires better understanding of patient experiences and preferences for participation. ⋯ Patients' participation is related to the healthcare system, the activity of healthcare professionals' and patients' capacity for participation. Patients prefer a handover process where the responsibility is clear and unambiguous. Healthcare organisations need a clear and well-considered system of responsibility for handover processes, that takes into account the individual patient's need of clarity, and support in relation to his/hers own recourses.
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BMJ quality & safety · Dec 2012
The Handover Toolbox: a knowledge exchange and training platform for improving patient care.
Safe and effective patient handovers remain a global organisational and training challenge. Limited evidence supports available handover training programmes. Customisable training is a promising approach to improve the quality and sustainability of handover training and outcomes. ⋯ The design of the Handover Toolbox was based on a carefully led stakeholder participatory design using the TEL-DP approach. The Toolbox supports a customisable learning approach that allows trainers to design training that addresses the specific information needs of the various target groups. We offer recommendations regarding the application of the Handover Toolbox to medical educators.
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BMJ quality & safety · Dec 2012
Technology support of the handover: promoting observability, flexibility and efficiency.
Efforts to standardise data elements and increase the comprehensiveness of information included in patient handovers have produced a growing interest in augmenting the verbal exchange of information with written communications conducted through health information technology (HIT). ⋯ Anticipated benefits of technology-supported handovers include reducing reliance on human memory, increasing the efficiency and structure of the verbal exchange, avoiding readbacks of numeric data, and aiding clinical management following the handover. In cases when verbal handovers are delayed, do not occur, or involve members of the health care team without first-hand access to critical information, making 'common ground' observable for all recipients, creating a flexible narrative structure for communication and avoiding reliance on real-time data entry during the busiest times has implications for HIT design and day to day data entry and management operations. Benefits include increased observability, flexibility, and efficiency of HIT-supported patient handovers.
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BMJ quality & safety · Dec 2012
Context, culture and (non-verbal) communication affect handover quality.
Transfers of care, also known as handovers, remain a substantial patient safety risk. Although research on handovers has been done since the 1980s, the science is incomplete. Surprisingly few interventions have been rigorously evaluated and, of those that have, few have resulted in long-term positive change. Researchers, both in medicine and other high reliability industries, agree that face-to-face handovers are the most reliable. It is not clear, however, what the term face-to-face means in actual practice. ⋯ Attention to patterns of NVB in face-to-face handovers coupled with education and practice can improve quality and reliability.