The Handover Toolbox: a knowledge exchange and training platform for improving patient care

Drachsler, H., Kicken, W., Van der Klink, M., Stoyanov, S., Boshuizen, H. P. A., & Barach, P. (2012). The Handover Toolbox: a knowledge exchange and training platform for improving patient care. British Medical Journal Quality & Safety, 21, 1114–1120. doi:10.1136/bmjqs-2012-001176Objective Safe and effective patient handovers remain a global organizational and training challenge. The World Health Organization (WHO) lists effective handovers as one of its High 5 patient safety initiatives. Training for handover competencies is a promising approach to improve the quality of handovers. We present the Handover toolbox that aims to support different stakeholders (e.g. general practitioners, nurses, medical trainer, experts in patient handover, and medical students) to provide customized handover training for specific demands. Methods The Handover toolbox was designed in the context of the FP7 HANDOVER project from April 2009 until October 2011 by using the Technology Enhanced Learning Design Process (TEL-DP). TEL-DP consisted of six different methods: 1). User requirements analysis; 2). Writing personas; 3). Group Concept Mapping 4). Analysis of suitable software; 5). Plus-Minus-Interesting rating; and 6). Usability testing. TEL-DP is aligned to participatory design approaches and guaranteed a development process in close collaboration with the stakeholders. Results From method (1) it appeared that different kinds of trainings are needed that allow to train professionals on the job as well as medical students in their studies. Methods (2) and (3) made clear that training experts from different countries differed in their views on the desired content and delivery of handover training. This means that a one-size-fits-all training was not applicable rather a customisable learning approach, a toolbox, that allow trainers to design their own training for various target groups with specific handover information needs was a far better solution. Method (4) identified the most suitable ready-to-use software systems that provided the required functionalities and could be further customized to the needs of the users. Method (5) and (6) resulted in several points for improvement of the Handover toolbox, mainly related to improved usability and navigation. Until the end of the development process in October 2011, 165 training experts were attracted by the toolbox and signed up for the system. Conclusions We developed a Handover toolbox for different stakeholders who are interested in improving handovers through customized training and learning. Its design is based on a carefully stakeholder investigation, using the TEL-DP approach which is a systematic and comprehensive design approach. It provides state of the art content about 40 handover tools with practical guidelines, a generic training design that can be customized to specific handover training needs, and enables community members to contribute own experiences and best practice examples. Next to this content, it offers an easy to use e-learning environment to support trainers in their handover classes. The developments can only be seen as a first supportive step to achieve a better patient safety. The final implementation phase of the toolbox has only partly been achieved within the FP7 HANDOVER project. Europe’s medical schools need additional support to implement the toolbox into their medical education system. Therefore, a follow-up implementation project was designed that will apply the toolbox in three University Hospitals in Germany, Spain, and Ireland.FP7 Handover, LLP PATIEN