Royal College of Surgeons in Ireland
Daily handover in surgery. systematic review and a novel taxonomy of interventions and outcomes.pdf (315.89 kB)

Daily handover in surgery: systematic review and a novel taxonomy of interventions and outcomes

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posted on 2024-05-07, 09:18 authored by Jessica RyanJessica Ryan, Fiachra McHugh, Anastasija SimicevaAnastasija Simiceva, Walter Eppich, Dara KavanaghDara Kavanagh, Deborah McNamaraDeborah McNamara

Background: Poor-quality handovers lead to adverse outcomes for patients; however, there is a lack of evidence to support safe surgical handovers. This systematic review aims to summarize the interventions available to improve end-of-shift surgical handover. A novel taxonomy of interventions and outcomes and a modified quality assessment tool are also described.

Methods: Ovid MEDLINE®, PubMed, Embase, and Cochrane databases were searched for articles up to April 2023. Comparative studies describing interventions for daily in-hospital surgical handovers between doctors were included. Studies were grouped according to their interventions and outcomes.

Results: In total, 6139 citations were retrieved, and 41 studies met the inclusion criteria. The total patient sample sizes in the control and intervention groups were 11 946 and 11 563 patients, respectively. Most studies were pre-/post-intervention cohort studies (92.7%), and most (73.2%) represented level V evidence. The mean quality assessment score was 53.4% (17.1). A taxonomy of handover interventions and outcomes was developed, with interventions including handover tools, process standardization measures, staff education, and the use of mnemonics. More than 25% of studies used a document as the only intervention. Overall, 55 discrete outcomes were assessed in four categories including process (n = 27), staff (n = 14), patient (n = 12) and system-level (n = 2) outcomes. Significant improvements were seen in 51.8%, 78.5%, 58.3% (n = 9761 versus 9312 patients) and 100% of these outcomes, respectively.

Conclusions: Most publications demonstrate that good-quality surgical handover improves outcomes and many interventions appear to be effective; however, studies are methodologically heterogeneous. These novel taxonomies and quality assessment tool will help standardize future studies.


Bon Secours Hospital in Dublin, Ireland, via the Royal College of Surgeons in Ireland (RCSI) StAR MD Programme (grant agreement 22253A01)

Medical Protection Society (MPS) Foundation (grant agreement 23017A01)


Data Availability Statement

Additional data have not been published in a public repository. The authors agree to make the data, analytic methods and study materials available to other researchers. These can be obtained by contacting the corresponding author using the details provided


The original article is available at

Published Citation

Ryan JM. et al. Daily handover in surgery: systematic review and a novel taxonomy of interventions and outcomes. BJS Open. 2024 Mar 1;8(2):zrae011.

Publication Date

1 March 2024

PubMed ID



  • Beaumont Hospital
  • SIM Centre for Simulation Education and Research
  • Surgical Affairs
  • Surgery


Oxford University Press (OUP)


  • Published Version (Version of Record)

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