Discussion and recommendations
Clinical handoff is a tool for healthcare
providers which can lead to positive patient outcomes.
Since handoff breakdown has been widely
experienced, a number of interventions aimed at
improving handoff have been attempted. However,
the impacts of these interventions were assessed
for different targets. Some seemed to benefit
patients. However, those outcomes were indirectly
measured through the healthcare providers’ perceptions
which were vulnerable to subjective bias.
Some enhanced system functions which resulted
in more efficient work and some improved quality
of the information transferred, but the effects of
these interventions on patient outcomes could not
be substantiated. The lack of valid measurements
of patient outcomes and ethical considerations
relating to patient harm could make it difficult and
complex to evaluate the impacts of interventions
directly on patient outcomes. There is, therefore,
little empirical evidence in the literature as to
how interventions were able to bring about better
patient outcomes. Of the studies reviewed, only
a few studies directly evaluated patient outcomes.
In selecting interventions aimed at improving
handoffs, organizations should consider which
method is most appropriate to their setting, depending
on the expected outcomes and available
resources. The applicability of the interventions
selected should be carefully and thoroughly
considered prior to implementation. Table 1 also
summarizes the strengths and weaknesses of the
interventions described in the studies reviewed,
together with recommendations for implementing