The Effects of Patient Handoff Characteristics on Subsequent Care: A Systematic Review and Areas for Future Research

Purpose To summarize the available evidence about patient handoff characteristics and their impact on subsequent patient care in hospitals. Method In January and February 2011, the authors searched the Cochrane Central Register of Controlled Trials, PubMed, Embase, CINAHL, PsycINFO, ERIC, ISI Web of Science, and the reference lists of relevant articles to carry out their systematic review. They selected articles that (1) had patient handoffs in hospitals as their explicit research focus and (2) reported at least one statistical test of an association between a handoff characteristic and outcome. They assessed study quality using 11 quality indicators. Results The authors identified 18 articles reporting 37 statistical associations between a handoff characteristic and outcome. The only handoff characteristic investigated in more than one study was the use of a standardized handoff sheet. Seven of those 12 studies reported significant improvements after introduction of the sheet. Four of the 18 studies used a randomized controlled trial design. Conclusions Published research is highly diverse and idiosyncratic regarding the handoff characteristics and outcomes assessed and the methodologies used, so comparing studies and drawing general conclusions about the field are difficult endeavors. The quality of research on the topic is rather preliminary, and there is not yet enough research to inform evidence-based handoff strategies. Future research, then, should focus on research methods, which outcomes should be assessed, handoff characteristics beyond information transfer, mechanisms that link handoff characteristics and outcomes, and the conditions that moderate the characteristics' effects.