Educational interventions to improve handover in health care: an updated systematic review

Abstract

Effective handovers (handoffs) are vital to patient safety. Educational interventions to improve handovers were previously investigated through a systematic review in 2010.1 The number of publications on handover education has increased substantially in recent years, so an update review was undertaken. Studies involving educational interventions to improve handover amongst undergraduate or postgraduate health professionals in acute care settings were considered. A standardized search of online databases was carried out independently by two authors and consensus reached. Data extraction and quality assessment were also completed independently, after which a content analysis of interventions was conducted and key themes extracted. Eighteen studies met the inclusion criteria, with all but two based in the US. Interventions most commonly used single-patient exercises based on simulation and role-play. Many discussed multi-professional working, but were largely taught in single professional contexts. Analysis of interventions revealed themes in three major areas: facilitating information management, reducing the potential for errors and improving confidence in participating in handovers. The majority of studies assessed Kirkpatrick’s outcomes of knowledge and skill improvement. The strength of conclusions was generally weak. Despite increased interest and publications on handover, the quality of published research remains poor. Inadequate reporting of interventions, especially as it relates to educational theory, pedagogy, curricula, and resource requirements, continues to impede replication. Weaknesses in quality of study, length of follow up and scope of impact evaluation persist. Future work is vital to address these issues, and to consider the role of multi-professional and multi-patient handovers.