Going the extra mile — cross-border patient handover in a European border region: qualitative study of healthcare professionals’ perspectives

Abstract

BackgroundCross-border healthcare is complex, increasingly frequent and causes potential risks for patient safety. In this context, cross-border handovers or the transfer of patients from one country to another deserves particular attention. Although general handover has been the topic of extensive research, little is known about the challenges of handover across national borders, especially as perceived by stakeholders. In this study, we aimed to gain insight into healthcare professionals’ perspectives on cross-border handover and ways to support this.MethodsWe conducted semistructured interviews with healthcare professionals (physicians, nurses, paramedics and administrative staff) in a European border region to investigate their perspectives on cross-border handover. The interviews were aimed to investigate settings of acute and planned handover. Informed by the theory of planned behaviour (TPB), interviews focused on participant perspectives. We summarised all interviews and inductively identified healthcare professionals’ perspectives. We used elements of the TPB as sensitising concepts.ResultsForty-three healthcare professionals participated. Although respondents had neutral to positive attitudes, they often did not know very well what was expected of them or what influence they could have on improving cross-border handover. Challenges covered five themes: information transfer, language barriers, task division and education, policy and financial structures and cultural differences. To overcome these challenges, we proposed strategies such as providing tools and protocols, discussing and formalising collaboration, and organising opportunities to meet and get to know each other.ConclusionHealthcare professionals involved in cross-border handovers face specific challenges. It is necessary to take measures to come to a shared understanding while paying special attention to the above-mentioned challenges. Meeting in person around meaningful activities (eg, training and case discussions) can facilitate sharing ideas and community building.

Inter-Regional Hospital Patients’ Mobility in Italy

“…Medical care offered to patients willing to travel for care includes a wide variety of services such as bio-ethical treatments (fertility, transplantation, and stem cell therapies), diagnostic tests, dental care, and surgery (cosmetic, orthopedic, Healthcare 2021, 9, 1182 2 of 16 bariatric, ophthalmology, and heart). In the recent years, healthcare mobility has developed rapidly and grown in social importance: especially in Europe, where a relatively large number of people are already receiving cross-border healthcare for elective or acute treatment, due to the European Union actively supporting patients in seeking cross-border healthcare by disseminating information through brochures, fact sheets and specialized contact points [3][4][5][6].…”

Overly optimistic picture of current state of cross-border patient care in ‘Going the extra mile’ study

“…Moreover, we were surprised by the fact that the healthcare professionals participating in the study of Beuken et al 1 showed little awareness of the burden current cross-border healthcare arrangements put on patients. Examples of frequently reported barriers relate to the use of prior authorisation, administrative requirements and reimbursement systems 4 5.…”

“…As international health services researchers, we read the paper by Beuken et al 1 with great interest. However, in our opinion the authors are too optimistic about the actual volume of current cross-border healthcare.…”

Patient handover in a European border region: Cross-sectional survey study among healthcare workers to explore the status quo, potential risks, and solutions

“…A recent study, in settings where collaboration across borders is already the order of the day, showed that healthcare workers also struggle with these topics during patient handover. 16 Since this is a crucial and hazardous moment in the transfer of patients in the international setting, it is vital to find out which additional factors might enhance or hinder international patient handovers, and how to resolve patient safety risks. The aim of this study is to (1) investigate the current situation regarding international patient handovers in a European border region, asking healthcare workers about experiences with local handover, international handover, procedures and checklists used, safety culture, and training, and to (2) explore the perceptions of healthcare workers about the risks and possible solutions regarding international patient handovers in their region.…”