Inter-department patient handoff quality and its contributing factors in Chinese hospitals
- 65 Downloads
The aims of the current study were to obtain factors contributing to inter-department patient handoff quality and to uncover characteristics of the current handoffs from the point of view of Chinese healthcare staff. A questionnaire was developed to obtain the staff’s views on inter-department handoffs. An online questionnaire survey was conducted between December 2016 and March 2017. A total of 490 valid responses were collected from physicians, nurses, and assistant nurses. Five handoff factors were derived by applying principal component analysis with 44% of cumulative variance accounted for. Significant differences were observed across three professional groups and assistant nurses had the most negative evaluations. However, a similar trend of views was shared, i.e., they showed a good understanding of their own roles and adequate communication during handoffs. In contrast, it was observed that patient care responsibility and information were sometimes discontinued. From the point of view of staff, the overall handoff quality was mainly affected by mutual communication, the handoff system and environment. The inadequacy of information transfer frequency was reported to be higher when receiving patients than when sending patients, particularly when receiving patients from the emergency or outpatient departments. Generally, healthcare staff in China had a high estimation of the overall quality and safety of inter-department patient handoffs. However, it was observed that information and responsibility were sometimes transferred inadequately. To resolve this discontinuity, we suggest a standardized handoff process, effective use of unlicensed staff and fostering a culture of error reporting and learning.
KeywordsPatient handoff Communication Patient safety Insufficient information
This work was in part supported by Grant-in-Aid for Young Scientists (B) (No. 15K16291), Japan Society for the Promotion of Science. The authors thank Lifang Chen, RN, No.3 People’s Hospital of Chengdu, China, for her insightful discussions and comments. The authors also thank to the risk management personnel, physicians and nurses who participated in interviews and discussions for providing us with variable information about patient handoffs.
This study was funded by Grant-in-Aid for Young Scientists (B) (No. 15K16291), Japan Society for the Promotion of Science.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Informed consent was obtained from respondents as described in “Survey sample” section.
- British Medical Association (2005) Safe handover: Safe patients. Guidance on clinical handover for clinicians and managers. https://www.bma.org.uk/-/media/Files/PDFs/Practical%20advice%20at%20work/Contracts/safe%20handover%20safe%20patients.pdf. Accessed 20 Apr 2018
- Gonzalo JD, Yang JJ, Stuckey HL, Fischer CM, Sanchez LD, Herzig SJ (2014) Patient care transitions from the emergency department to the medicine ward: evaluation of a standardized electronic signout tool. Int J Qual Health Care 26:337–347. https://doi.org/10.1093/intqhc/mzu040 CrossRefGoogle Scholar
- Gu X, Seki T, Itoh T (2017a) Developing an error taxonomy system for patient handoff events. Proceedings of The IEEE International Conference on Industrial Engineering and Engineering Management-IEEM 2017, Singapore, December 2017Google Scholar
- Gu X, Liu H, Itoh K (2017b) Patient handoff quality and safety in China: Health care providers’ views. Proceedings of European Safety and Reliability Conference—ESREL 2017, Portoroz, Slovenia, June 2017. In: Cepin, Briš (eds.) Safety and reliability—theory and applications. Taylor & Francis Group, London, pp 1675–1682Google Scholar
- Hair JF, Black WC, Babin BJ, Anderson RE, Tatham RL (2006) Multivariate data analysis. 6th edn. Pearson Prentice Hall, Upper Saddle RiverGoogle Scholar
- Lawrence S, Spencer LM, Sinnott M, Eley R (2015) It takes two to tango: improving patient referrals from the emergency department to inpatient clinicians. Ochsner J 15:149–153Google Scholar
- McElroy LM, Macapagal KR, Collins KM, Abecassis MM, Holl JL, Ladner DP, Gordon EJ (2015) Clinician perceptions of operating room to intensive care unit handoffs and implications for patient safety: a qualitative study. Am J Surg 210:629–635. https://doi.org/10.1016/j.amjsurg.2015.05.008 CrossRefGoogle Scholar
- Nunnally JC (1978) Psychometric theory. 2nd edn. McGraw-Hill, New YorkGoogle Scholar
- Organization for Economic Cooperation and Development (2017) Health at a glance 2017: OECD indicators. https://read.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-2017_health_glance-2017-en#page1. Accessed 20 Apr 2018
- Rayo MF, Mount-Campbell AF, O’Brien JM, White SE, Butz A, Evans K, Patterson ES (2014) Interactive questioning in critical care during handovers: a transcript analysis of communication behaviours by physicians, nurses and nurse practitioners. BMJ Qual Saf 23:483–489. https://doi.org/10.1136/bmjqs-2013-002341 CrossRefGoogle Scholar
- Riesenberg LA, Leitzsch J, Cunningham JM (2010) Nursing handoffs: a systematic review of the literature. Am J Nurs 110:24–34. https://doi.org/10.1097/01.NAJ.0000370154.79857.09 (quiz 35–26) CrossRefGoogle Scholar
- van Sluisveld N, Hesselink G, van der Hoeven JG, Westert G, Wollersheim H, Zegers M (2015) Improving clinical handover between intensive care unit and general ward professionals at intensive care unit discharge. Intensive Care Med 41:589–604. https://doi.org/10.1007/s00134-015-3666-8 CrossRefGoogle Scholar
- WHO Patient Safety Alliance (2007) Communication during patient hand-overs: Patient safety solutions, volume 1, solution 3. http://www.who.int/patientsafety/solutions/patientsafety/PS-Solution3.pdf. Assessed 20 Apr 2018