Exploring patient participation in reducing health-care-related safety risks

Exploring patient participation in reducing health-care-related safety risks
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hospital and primary care is a serious barrier to effective and safe discharge, especially
with complex patient care in which continuity of care is essential. The lack of awareness
of different professional perspectives inherent within primary and secondary professional
domains seems to influence roles and responsibilities in patient diagnosis and treatment.
Though most professionals think they carry a shared responsibility in this respect, in
practice they do not. Because of multiple assigned roles and unclear responsibilities,
especially for nursing professionals, barriers to effective handover also exist at patient
discharge. It is common for the GP to play an essential part in the coordination of
patient care. However, as already mentioned, multiple factors make this role difficult
to fulfil.
(e) Barriers to success
Current interventions aimed at improving patient handover at the hospital–primary care
interface fall short in terms of addressing the large number of barriers and facilitators
that influence effective handover. However, effective handover interventions are mostly
aimed at improving organizational and technical aspects of the handover process.
(f ) Quality improvement tools
The effectiveness and efficiency of various methods and tools used in the first major
European study to improve patient handovers were determined. The triangulation of
multimodal improvement science methods in this study – including analyses of barriers
and facilitators using Ishikawa diagrams and process maps, as well as analyses of roles
and responsibilities, near misses and so on – is innovative and has applications across
Europe, which could facilitate crosscountry learning to advance the quality of care.
Future
The HANDOVER Toolbox initiative 4 has been successfully piloted and is ready for
implementation. This interactive online platform has been successfully developed to
encourage a community of users to design and share ideas and best practices concerning
effective handover of patients. The European HANDOVER Research Collaborative is
committed to continuing this work.
References
1. Handover [web site]. Utrecht, University Patient Medical Centre Utrecht, 2009
(www.handover.eu, accessed 1 May 2012).
2. Handover toolbox [web site]. Utrecht, University Patient Medical Centre Utrecht,
2009 (www.handover.ou.nl, accessed 1 May 2012).
Bibliography
Barach P, Johnson J. Assessing risk and harm in the clinical microsystem: a systematic
approach to patient safety. In: Sollecito W, Johnson J, eds. Continuous quality
improvement in health care: theory, implementations and applications, 4th ed. Burlington,
MA, Jones and Bartlett Learning, 2011:249–274.
4 See the European Handover Research Collaborative web site for more details (2).