The Effectiveness of Standardized Handoff Tool Interventions During Inter- and Intra-facility Care Transitions on Patient-Related Outcomes: A Systematic Review

Abstract

Improving physician handoffs is a patient safety priority. The authors hypothesize that standardized handoff interventions during care transitions improve patient-related outcome measures. PubMed, Cochrane, PsycINFO, CINAHL, Embase, and Web of Science were searched for publications from 2000 to May 2016. Eligible studies compared standardized handoff intervention(s) with no standardized handoff intervention and measured patient-related outcomes. Studies were evaluated independently for eligibility for inclusion by at least 2 authors in a 2-stage process; 14 articles met inclusion criteria. Only 1 study examined inter-facility transfers. Five categories of patient-related outcomes were identified: clinical complications, length of stay, processes of care, adverse events and errors, and family satisfaction. Interventions consistently improved processes of care; interventions consistently did not affect mortality. The other outcomes demonstrated mixed results. Inconsistent results, heterogeneity of the outcome measures, and limited quality studies limit the ability to draw definitive conclusions about best practices for standardized handoffs during care transitions.