End-of-shift surgical handover: mixed-methods, multicentre evaluation and recommendations for improvement

Handover is defined as ‘the exchange between health professionals of information about a patient’ and accompanies a transfer of responsibility for that patient. Ineffective handover harms patients, incurs significant monetary and opportunity costs, and causes 40% of communication-related malpractice claims. Surgical patients are vulnerable to such communication failures.

Despite published handover guidelines, implementation is poor and no ‘standard’ exists. Previous studies have audited surgical handover; however, few used qualitative methods to explore the impact of behaviours and context, and no interventional studies rigorously applied an implementation framework, so enablers and barriers remain poorly understood. A comprehensive mixed-methods evaluation of surgical handover is required to determine the causes of poor compliance with guidelines.

The aim of this study was to assess adherence to international guidelines during post-call general surgical handover, to identify barriers to guideline compliance and to develop recommendations for process improvements.