Practice Essentials

Safe handover

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4328 (Published 09 October 2017) Cite this as: BMJ 2017;359:j4328
  1. Hanneke Merten, researcher in quality and safety in healthcare1,
  2. Louise S van Galen, research fellow in patient safety in the acute healthcare chain2,
  3. Cordula Wagner, director of NIVEL, professor of patient safety1 3
  1. 1Department of Public and Occupational Health, VU University Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands
  2. 2Department of Internal Medicine, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands
  3. 3NIVEL, Otterstraat 118-124, 3513CR Utrecht, Netherlands
  1. Correspondence to: H Merten h.merten{at}vumc.nl

What you need to know

  • Information shared during clinical handover includes, as a minimum, the patient’s current health status, medications, and treatment plans as well as advance directives and any important changes in the patient’s status

  • Tools and handover structures such as SBAR (Situation, Background, Assessment, Recommendation) have been shown to improve the quality of handovers

  • Involving patients and carers in handovers—including scheduling a timely discharge conversation to discuss aspects of their admission and follow-up plan that includes a personalised discharge letter—is of great value.

High quality handovers are essential for safe healthcare and are used in many clinical situations. Miscommunication during handovers can lead to unnecessary diagnostic delays, patients not receiving required treatment, and medication errors.1 Miscommunication is one of the leading causes for adverse events resulting in death or serious injury to patients.2 The process of handovers can be improved, and the aim of this article is to provide practical guidance for clinicians on how to do this better.

What is a handover?

A handover involves the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or groups of patients, to another person, such as a clinician or nurse, or professional group on a temporary or permanent basis.3 Ideally a professional can take over responsibility for a patient only if he or she receives all relevant information to continue the treatment or care effectively and safely.

Sources and selection criteria

We searched PubMed and the Cochrane review library (until April 2017) to identify original research studies for clinical handovers and the effectiveness of tools to improve handovers. We searched Medline using the MeSH term “patient handoff” with all related terms in the MeSH hierarchy (such as handover). This resulted in 626 potentially relevant papers. Additionally, we used the general search term “clinical handover” which resulted in 1206 potentially relevant papers. Titles …

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