Improving patient handovers from hospital to primary care:
a systematic review
Improving patient handovers from hospital to primary care:
a systematic review
Background: Evidence shows that suboptimum handovers at hospitaldischarge lead to increased rehospitalizations and decreased quality of health care.
Purpose: To systematically review interventions that aim to improve patient discharge from hospital to primary care.
Data Sources: PubMed, CINAHL, PsycInfo, the Cochrane Library,and EMBASE were searched for studies published between January 1990 and March 2011.
Study Selection: Randomized, controlled trials of interventions that aimed to improve handovers between hospital and primary care providers at hospital discharge.
Data Extraction: Two reviewers independently abstracted data on study objectives, setting and design, intervention characteristics,and outcomes. Studies were categorized according to methodological quality, sample size, intervention characteristics, outcome, statistical
significance, and direction of effects.
Data Synthesis: Of the 36 included studies, 25 (69.4%) had statistically significant effects in favor of the intervention group and 34 (94.4%) described multicomponent interventions. Effective interventions included medication reconciliation; electronic tools to facilitate quick, clear, and structured summary generation; discharge
planning; shared involvement in follow-up by hospital and community care providers; use of electronic discharge notifications; and Web-based access to discharge information for general practitioners.
Statistically significant effects were mostly found in reducing hospital use (for example, rehospitalizations), improvement of continuity of care (for example, accurate discharge information), and improvement of patient status after discharge (for example,satisfaction).
Limitations: Heterogeneity of the interventions and study characteristics made meta-analysis impossible. Most studies had diffuse aims and poor descriptions of the specific intervention components.
Conclusion: Many interventions have positive effects on patient care. However, given the complexity of interventions and outcome measures, the literature does not permit firm conclusions about which interventions have these effects.
417-428
Hesselink, G.
4156a7fb-a6b3-4ba8-bddd-7394c22b0f32
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Barach, P.
69ad6a57-8f9c-4a35-af61-f147784a09a1
Spijker, A.
a5605de1-2fe7-4852-8f2d-4257c9332cb9
Gademan, P.
36e1600c-cf99-4c2d-a1cd-ea3b96d089cc
Kalkman, C.
d2b2ba91-eb39-4fbc-95d5-f7b6b37b139d
Liefers, J.
48d8cb7c-a9c4-4634-b93e-84cefd0f7338
Vernooij-Dassen, M.
c1923cc4-6d57-4d0a-8810-e90ba35279e1
Wollersheim, H.
5e67270e-394d-41b8-b2c3-d0c7d14f00e7
2012
Hesselink, G.
4156a7fb-a6b3-4ba8-bddd-7394c22b0f32
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Barach, P.
69ad6a57-8f9c-4a35-af61-f147784a09a1
Spijker, A.
a5605de1-2fe7-4852-8f2d-4257c9332cb9
Gademan, P.
36e1600c-cf99-4c2d-a1cd-ea3b96d089cc
Kalkman, C.
d2b2ba91-eb39-4fbc-95d5-f7b6b37b139d
Liefers, J.
48d8cb7c-a9c4-4634-b93e-84cefd0f7338
Vernooij-Dassen, M.
c1923cc4-6d57-4d0a-8810-e90ba35279e1
Wollersheim, H.
5e67270e-394d-41b8-b2c3-d0c7d14f00e7
Hesselink, G., Schoonhoven, Lisette, Barach, P., Spijker, A., Gademan, P., Kalkman, C., Liefers, J., Vernooij-Dassen, M. and Wollersheim, H.
(2012)
Improving patient handovers from hospital to primary care:
a systematic review.
Annals of Internal Medicine, 157 (6), .
(doi:10.7326/0003-4819-157-6-201209180-00006).
Abstract
Background: Evidence shows that suboptimum handovers at hospitaldischarge lead to increased rehospitalizations and decreased quality of health care.
Purpose: To systematically review interventions that aim to improve patient discharge from hospital to primary care.
Data Sources: PubMed, CINAHL, PsycInfo, the Cochrane Library,and EMBASE were searched for studies published between January 1990 and March 2011.
Study Selection: Randomized, controlled trials of interventions that aimed to improve handovers between hospital and primary care providers at hospital discharge.
Data Extraction: Two reviewers independently abstracted data on study objectives, setting and design, intervention characteristics,and outcomes. Studies were categorized according to methodological quality, sample size, intervention characteristics, outcome, statistical
significance, and direction of effects.
Data Synthesis: Of the 36 included studies, 25 (69.4%) had statistically significant effects in favor of the intervention group and 34 (94.4%) described multicomponent interventions. Effective interventions included medication reconciliation; electronic tools to facilitate quick, clear, and structured summary generation; discharge
planning; shared involvement in follow-up by hospital and community care providers; use of electronic discharge notifications; and Web-based access to discharge information for general practitioners.
Statistically significant effects were mostly found in reducing hospital use (for example, rehospitalizations), improvement of continuity of care (for example, accurate discharge information), and improvement of patient status after discharge (for example,satisfaction).
Limitations: Heterogeneity of the interventions and study characteristics made meta-analysis impossible. Most studies had diffuse aims and poor descriptions of the specific intervention components.
Conclusion: Many interventions have positive effects on patient care. However, given the complexity of interventions and outcome measures, the literature does not permit firm conclusions about which interventions have these effects.
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Published date: 2012
Organisations:
Faculty of Health Sciences
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Local EPrints ID: 351728
URI: http://eprints.soton.ac.uk/id/eprint/351728
ISSN: 0003-4819
PURE UUID: 5f931166-20a0-4576-a68b-b932633606ad
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Date deposited: 24 Apr 2013 14:35
Last modified: 15 Mar 2024 03:41
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Author:
G. Hesselink
Author:
P. Barach
Author:
A. Spijker
Author:
P. Gademan
Author:
C. Kalkman
Author:
J. Liefers
Author:
M. Vernooij-Dassen
Author:
H. Wollersheim
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