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Postoperative patient handovers are fraught with technical and communication errors and may negatively impact patient safety. We systematically reviewed the literature on handover of care from the operating room to postanesthesia or intensive care units and summarized process and communication recommendations based on these findings. From >500 papers, we identified 31 dealing with postoperative handovers. Twenty-four included recommendations for structuring the handover process or information transfer. Several recommendations were broadly supported, including (1) standardize processes (e.g., through the use of checklists and protocols); (2) complete urgent clinical tasks before the information transfer; (3) allow only patient-specific discussions during verbal handovers; (4) require that all relevant team members be present; and (5) provide training in team skills and communication. Only 4 of the studies developed an intervention and formally assessed its impact on different process measures. All 4 interventions improved metrics of effectiveness, efficiency, and perceived teamwork. Most of the papers were cross-sectional studies that identified barriers to safe, effective postoperative handovers including the incomplete transfer of information and other communication issues, inconsistent or incomplete teams, absent or inefficient execution of clinical tasks, and poor standardization. An association between poor-quality handovers and adverse events was also demonstrated. More innovative research is needed to define optimal patient handovers and to determine the effect of handover quality on patient outcomes.

Objectives The authors conducted a randomised controlled trial of four pedagogical methods commonly used to deliver teamwork training and measured the effects of each method on the acquisition of student teamwork knowledge, skills, and attitudes. Methods The authors recruited 203 senior nursing students and 235 fourth-year medical students (total N¼438) from two major universities for a 1-day interdisciplinary teamwork training course. All participants received a didactic lecture and then were randomly assigned to one of four educational methods: didactic (control), audience response didactic, role play and human patient simulation. Student performance was assessed for teamwork attitudes, knowledge and skills using: (a) a 36-item teamwork attitudes instrument (CHIRP), (b) a 12-item teamwork knowledge test, (c) a 10-item standardised patient (SP) evaluation of student teamwork skills performance and (d) a 20-item modification of items from the Mayo High Performance Teamwork Scale (MHPTS The TeamSTEPPS programme is designed to improve care and patient safety through improved teamwork training to enhance provider communication skills. While the 7 h multidisciplinary Team-STEPPS programme has proven very effective, questions remain regarding the most effective and cost-efficient approach to providing this content to learners at all stages of the health-education continuum.Various educational approaches have been used to address training in team coordination skills in healthcare. Methods such as crisis resource management training using high fidelity human patient simulation provide realism and interactivity.1e3 However, this training modality is both costly and time-consuming, with one instructor per five trainees costing as much as $5000 per day. 12Because of this, medical and nursing schools are implementing more traditional didactic approaches to teaching team coordination skills as well as computer-based instruction, small-group sessions, analysis of videotaped team coordination scenarios and workplace practice experiences.10 11 13 Questions remain about the effectiveness of any of these methods to achieve the necessary changes in student attitudes, knowledge and skills, and there is little evidence for selecting particular methods. Therefore, this study was designed and implemented to adapt the TeamSTEPPS content to pre-licensure nursing and medical students, and measure the effectiveness of four educational interventions at teaching this material. METHODS ProtocolWe conducted a full-day teamwork training and assessment exercise for 438 students composed of fourth-year medical students (N¼235) and finalsemester nursing students (N¼203) from four health-professional schools at two major universities: all students convened on the one campus where they were randomised to one of four educational intervention groups. Students were offered the option of not participating in the research project but could not decline the educational experience. Institutional review boards of both universities approved the proj...