Investigating curriculum based training on patient handover within higher education institutions

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Date
2021-05
Authors
Muller, George Frederick
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Publisher
University of the Free State
Abstract
Background: Communication between healthcare providers (HCPs) is crucial for holistic patient care and conformance to the continuum of care. Patient handover is viewed as an essential element for aligning this continuum of care in the healthcare environment. The education of HCPs notoriously neglects the topic of patient handover through various healthcare programmes with minimal interprofessional education taking place. The South African Qualifications Authority (SAQA) and quality councils (Council on Higher Education, Umalusi, and Quality Council of Trades and Occupations), guided by the various professional healthcare boards, which provides the benchmark for healthcare education outcomes, fails to incorporate patient handover as a topic of interest into most healthcare programmes curricula. Programme-specific outcomes appear not to reflect patient handover as a priority in healthcare. Poor interprofessional communication is linked to one-quarter of all adverse medical events and prolonged patient admission, with massive cost implications related to the duplication of diagnostic testing. Interprofessional power gradients have been indicated to directly influence how patient handover is conducted. Aims and objectives: The aim of this study was to investigate the current status of patient handover from a theoretical and practical perspective. The objectives followed to achieve the aim included reviewing the curricula of healthcare programmes published by SAQA. A rapid literature review was conducted to ascertain what national and international recommendations can be made regarding patient handover protocols. An HCP questionnaire was constructed and disseminated to hospital healthcare providers (H-HCPs) and prehospital healthcare providers (P-HCPs) to determine their perceptions of current standards related to patient handover. Methodology: A sequential mixed-methods design was employed, following a more qualitative approach to data collection. Methods: A curriculum content review was conducted on the SAQA-published healthcare programme curricula, followed by a rapid literature review. The data from these phases were utilised to construct an HCP questionnaire, to incorporate both H-HCPs’ and P-HCPs’ responses. Results: The various methods in this study indicated that patient handover is minimally implemented throughout the various healthcare programmes’ curricula. Simulation-based medical education (SBME) was highlighted as the best method to incorporate patient handover education and to assess the topic. The various healthcare programmes indicated minimal structure during theoretical education, with emphasis on informal learning by higher education institutions (HEIs). P-HCPs indicated the most experience with internationally recognised handover acronyms, while H-HCPs indicated minimal experience on the same topic. There appears to be a large gap between what H-HCPs deem important information during patient handover and the information that P-HCPs hand over. None of the HCPs indicated satisfaction with how current handover practices are done, but most HCPs felt confident with handing over a patient holistically. Conclusions: The World Health Organization’s recommendation to incorporate patient handover into all HCP programmes is highly neglected. Even though patient handover is superficially covered in theory lectures, educational limitations still exist regarding how to incorporate patient handover into teaching and learning. Informal education forms a significant part of this academic topic, with no standard approach adopted in current healthcare systems by either H-HCPs or P-HCPs. Formal assessment on patient handover is not incorporated. SBME encourages the ideal platform for educating, assessing, and providing constructive feedback on patient handover. The theory-practice gap between HEIs and healthcare facilities expands daily. Little interprofessional education is incorporated into healthcare, which directly influences the gap between a unified healthcare system. The less time that is spent on interprofessional education, the greater this gap becomes. Recommendations: Interprofessional collaboration is required between the various healthcare programmes. Educational institution and HCP collaboration is necessary to increase healthcare programme curricula, while simultaneously adapting to both industry and patient needs.
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Keywords
Dissertation (M.HPE. (Health Professions Education))--University of the Free State, 2021, Curriculum development, Emergency care practitioners, Healthcare practitioner, Higher education institutions, Interdisciplinary, Interprofessional, Patient handoff, Patient handover
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