HANDOVER

Improving the Continuity of patient care Through Identification and implementation of Novel patient handoff processes in Europe

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 Obiettivo del progetto (Objective)

'Research has shown that every year 30,000 European patients suffer preventable harm during treatment. It is estimated there were potentially 1,735 avoidable deaths in 2004. The financial cost of avoidable adverse events is reckoned at €167 million, 1% of hospitals’ total budget, due to longer hospital stays and additional treatment. Many of these adverse events relate to handoff in care. Poor continuity of clinical care (with multiple provider involvement), either at a patient’s referral to a hospital by a primary care specialist or at a patient’s discharge from the hospital, is a critical aspect of a patient’s care. Incomplete handoffs to a secondary/tertiary care unit or discharge from hospital can lead to adverse events for patients that may ultimately lead to either life threatening situations during treatment/surgery or avoidable treatment and / or re-hospitalizations after the patient’s discharge. Care transitions are especially important for vulnerable groups as the elder and the very young as for high-risk patients with multiple co-morbidities. The overall objective the HANDOVER project is optimize the continuum of clinical care at the primary care hospital interface by reducing unnecessary and avoidable treatment - medical errors and loss of life, by identifying and studying best practices and creating standardized approaches to handoff communication at the primary care hospital interface and measuring the effectiveness of these practices in terms of costs and impact. Handoffs take as many forms as there are handoff scenarios. The idea of developing a single approach for all handoffs is not likely to be possible due to the diversity and complexity of healthcare. HANDOVER will therefore aim at providing standardised basic elements in handoff processes, which can be tailored to meet local and/or institutional needs for flexibility.'

Introduzione (Teaser)

There are many cases where patients are not discharged correctly from hospitals or become victims of negligence in handover procedures, often leading to catastrophic results. New guidelines and training tools may change this.

Descrizione progetto (Article)

Patient recovery doesn't generally end in the hospital. Patients are sometimes discharged inappropriately or too early from hospitals, as well as being given the wrong medication or incorrect advice. This has resulted in many complications for the patients and even tragic yet preventable deaths, as well as incurring huge costs on health systems.

The EU-funded project 'Improving the continuity of patient care through identification and implementation of novel patient handoff processes in Europe' (Handover) is developing new approaches to patient discharge and handoff.

While handoff cannot be standardised for all healthcare systems, the project is developing a standardised toolkit that helps institutions in the process, involving policymakers and educators as well.

The project is investigating patient handover practices in England, Italy, Netherlands, Poland, Spain and Sweden, collecting data from hundreds of physicians, nurses, patients and hospital managers. It is identifying the enablers and barriers within the social, medical and technological environments of handovers, especially communication failures. Once adverse outcomes and 'near misses' are identified, the project will develop tools and training programmes to improve handoff. It will then assess the cost effectiveness of optimised handovers.

The Handover project has already interviewed more than 160 healthcare professionals and shadowed healthcare workers to unveil the intricacies of this process. It has noted major differences in patient discharge, transfer and rehabilitation across the countries.

The project is currently outlining guidelines for clinical practice in this area, as well as best practices for undergraduate and postgraduate trainees in healthcare. This will streamline the handover process and standardise practices as much as possible, leading to a better system that improves well-being, saves lives and reduces healthcare costs.