The key actor : A qualitative study of patient participation in the handover process in Europe
Flink, Maria (Department of Social Work. Karolinska University Hospital)
Hesselink, Gijs (Radboud University Medical Centre. Scientific Institute for Quality of Healthcare)
Pijnenborg, Loes (Department on Quality and Safety. St. Antonius Hospital)
Wollersheim, Hub (Scientific Institute for Quality of Healthcare (IQ Healthcare). Radboud University Nijmegen Medical Centre)
Vernooij-Dassen, Myrra (Radboud University Medical Centre)
Dudzik-Urbaniak, Ewa (National Center for Quality Assessment in Health Care)
Orrego, Carola (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Toccafondi, Giulio (Clinical Risk Management and Patient Safety Centre)
Schoonhoven, Lisette (Faculty of Health Sciences. University of Southampton)
Gademan, Petra J. (Primary Health Care, Utrecht Area)
Johnson, Julie K. (Centre for Clinical Governance Research. University of New South Wales)
Oḧlén, Gunnar (Quality and Patient Safety. Karolinska University Hospital)
Hansagi, Helen (Karolinska Institutet (Estocolm, Suècia). Department of Clinical Neuroscience)
Olsson, Mariann (Department of Social Work. Karolinska University Hospital)
Barach, Paul (Department of Health Studies. University of Stavanger)

Data:	2012
Resum:	Background: Patient safety experts have postulated that increasing patient participation in communications during patient handovers will improve the quality of patient transitions, and that this may reduce hospital readmissions. Choosing strategies that enhance patient safety through improved handovers requires better understanding of patient experiences and preferences for participation. Objective: The aim of this paper is to explore the patients' experiences and perspectives related to the handovers between their primary care providers and the inpatient hospital. Methods: A qualitative secondary analysis was performed, based on individual and focus group patient interviews with 90 patients in five European countries. Results: The analysis revealed three themes: patient positioning in the handover process; prerequisites for patient participation and patient preferences for the handover process. Patients' participation ranged from being the key actor, to sharing the responsibility with healthcare professional(s), to being passive participants. For active participation patients required both personal and social resources as well as prerequisites such as information and respect. Some patients preferred to be the key actor in charge; others preferred their healthcare professionals to be the key actors in the handover. Conclusions: Patients' participation is related to the healthcare system, the activity of healthcare professionals' and patients' capacity for participation. Patients prefer a handover process where the responsibility is clear and unambiguous. Healthcare organisations need a clear and well-considered system of responsibility for handover processes, that takes into account the individual patient's need of clarity, and support in relation to his/hers own recourses.
Ajuts:	European Commission 223409
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Chronic Disease ; European Union ; Female ; Focus Groups ; General Practitioners ; Health Knowledge, Attitudes, Practice ; Humans ; Interviews as Topic ; Male ; Patient Handoff ; Patient Participation ; Patient Safety ; Patient Satisfaction ; Patients ; Physician-Patient Relations ; Qualitative Research ; Quality Assurance, Health Care
Publicat a:	BMJ Quality and Safety, Vol. 21 Núm. SUPPL. 1 (december 2012) , ISSN 2044-5415

DOI: 10.1136/bmjqs-2012-001171
PMID: 23112290

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