The key actor: a qualitative study of patient participation in the handover process in Europe

Abstract

Background: Patient safety experts have postulated thatincreasing patient participation in communications duringpatient handovers will improve the quality of patienttransitions, and that this may reduce hospital readmissions.Choosing strategies that enhance patient safety throughimproved handovers requires better understanding ofpatient experiences and preferences for participation.Objective: The aim of this paper is to explore the patients’experiences and perspectives related to the handoversbetween their primary care providers and the inpatienthospital.Methods: A qualitative secondary analysis was performed,based on individual and focus group patient interviews with90 patients in five European countries.Results: The analysis revealed three themes: patientpositioning in the handover process; prerequisites forpatient participation and patient preferences for thehandover process. Patients’ participation ranged from beingthe key actor, to sharing the responsibility with healthcareprofessional(s), to being passive participants. For activeparticipation patients required both personal and socialresources as well as prerequisites such as information andrespect. Some patients preferred to be the key actor incharge; others preferred their healthcare professionals to bethe key actors in the handover.Conclusions: Patients’ participation is related to thehealthcare system, the activity of healthcare professionals’and patients’ capacity for participation. Patients prefer ahandover process where the responsibility is clear andunambiguous. Healthcare organisations need a clear andwell-considered system of responsibility for handoverprocesses, that takes into account the individual patient’sneed of clarity, and support in relation to his/hers ownrecourses.

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ORCID for Lisette Schoonhoven: orcid.org/0000-0002-7129-3766

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