Cognition, Technology & Work

, Volume 21, Issue 1, pp 133–143 | Cite as

Inter-department patient handoff quality and its contributing factors in Chinese hospitals

  • Xiuzhu GuEmail author
  • Hu-chen Liu
  • Kenji Itoh
Original Article


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.


Patient 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

Informed consent was obtained from respondents as described in “Survey sample” section.


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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Industrial Engineering and Economics, School of EngineeringTokyo Institute of TechnologyTokyoJapan
  2. 2.Department of ManagementShanghai UniversityShanghaiChina

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