The key actor: a qualitative study of patient participation in the handover process in Europe

Abstract

BackgroundPatient safety experts have postulated that increasing patient participation in communications during patient handovers will improve the quality of patient transitions, and that this may reduce hospital readmissions. Choosing strategies that enhance patient safety through improved handovers requires better understanding of patient experiences and preferences for participation.ObjectiveThe aim of this paper is to explore the patients’ experiences and perspectives related to the handovers between their primary care providers and the inpatient hospital.MethodsA qualitative secondary analysis was performed, based on individual and focus group patient interviews with 90 patients in five European countries.ResultsThe analysis revealed three themes: patient positioning in the handover process; prerequisites for patient participation and patient preferences for the handover process. Patients’ participation ranged from being the key actor, to sharing the responsibility with healthcare professional(s), to being passive participants. For active participation patients required both personal and social resources as well as prerequisites such as information and respect. Some patients preferred to be the key actor in charge; others preferred their healthcare professionals to be the key actors in the handover.ConclusionsPatients’ participation is related to the healthcare system, the activity of healthcare professionals’ and patients’ capacity for participation. Patients prefer a handover process where the responsibility is clear and unambiguous. Healthcare organisations need a clear and well-considered system of responsibility for handover processes, that takes into account the individual patient's need of clarity, and support in relation to his/hers own recourses.

Situação Dos Hospitais De Referência Para Implantação/Funcionamento Do Núcleo De Segurança Do Paciente

“…Acredita-se que pacientes e familiares preferem participar do tratamento quando as responsabilidades são claramente atribuídas a eles por profissionais considerados de confiança e que acompanham o paciente. Pesquisas sugerem que pacientes e familiares tendem a uma maior adesão ao tratamento e colaboração à terapêutica quando julgam as instituições hospitalares confiáveis e seguras (20,21) . Há evidências de desfechos mais favoráveis quando paciente e familiares compreendem o problema e participam dos cuidados voltados à segurança e ao tratamento (21) .…”

The Handover Toolbox: a knowledge exchange and training platform for improving patient care

“…This section recognises that patients and their families are at the centre of the handover process and can play an important role in influencing the quality of handovers 37. It includes approaches for improving communication around handovers between patients and healthcare professionals, and was informed by the project's patient advisory group.…”

Redefining clinical leadership for team-course development

“…[65][66][67] Healthcare personnel and patients also emphasize values as important in providing patient-centered care and treatment. [68][69][70] Another strength of the CLT course is that the curriculum is rooted in the actual clinical setting of the participants using local, empirically based inputs for preparing, developing and sustaining CL in team skills. [37] Output of the CLT course will hopefully also in the long run demonstrate improvement in patient-centered care and workforce satisfaction through improved reflection and implementation of the four core values bedside.…”