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Handoff Education Interventions: A Scoping Review Focused on Sustaining Improvements
Lee Ann Riesenberg1, Joshua J Davis2, Elle Kaplan3
1Anesthesiology and Perioperative Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
Summary
Effective patient handoff education requires multi-modal interventions and reinforcement. Studies show sustained improvements in handoff skills and patient outcomes when educational strategies are comprehensive and include follow-up.
Area of Science:
- Healthcare Education
- Patient Safety
- Medical Handoffs
Background:
- Handoffs are critical for patient information and care transfer between healthcare professionals.
- Educational interventions are increasingly incorporated into handoff improvement strategies.
- Understanding the impact of these interventions on sustained change is crucial.
Purpose of the Study:
- To describe handoff studies incorporating education as an intervention.
- To explore the role of educational interventions in sustaining improvements in patient handoffs.
Main Methods:
- A scoping review of previously published systematic reviews and a systematic search of 5 databases (January 2006-June 2020).
- Data extraction by trained, independent reviewers.
- Identification of 74 relevant articles, with analysis of intervention components and reported outcomes.
Main Results:
- Most studies (70%) were published after 2015 and conducted in the US (76%).
- Common interventions included instruction (99%), skills practice (66%), memory aids (89%), and reinforcement (43%).
- A significant increase in reporting behavior change (17%-68%) and patient outcomes (11%-18%) was observed. Twelve studies demonstrated sustained change (≥6 months follow-up with statistically significant improvements).
- Sustained change was associated with multi-modal educational interventions and the use of reinforcement (75% in sustained vs. 37% in non-sustained studies).
Conclusions:
- Future handoff education should be guided by education theory, including needs assessment and measurable objectives.
- Multi-modal educational interventions with reinforcement are key for sustained handoff improvements.
- Future research should measure behavior change and patient outcomes, include long-term follow-up (>6 months), and adhere to education reporting guidelines.
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