• Maria Flink, Gijs Hesselink, Loes Pijnenborg, Hub Wollersheim, Myrra Vernooij-Dassen, Ewa Dudzik-Urbaniak, Carola Orrego, Giulio Toccafondi, Lisette Schoonhoven, Petra J Gademan, Julie K Johnson, Gunnar Öhlén, Helen Hansagi, Mariann Olsson, Paul Barach, and HANDOVER Research Collaborative.
• Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, B44, Karolinska Sjukhuset Huddinge, Stockholm 14186, Sweden. maria.flink@ki.se
• BMJ Qual Saf. 2012 Dec 1;21 Suppl 1:i89-96.

BackgroundPatient 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.ObjectiveThe 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.MethodsA qualitative secondary analysis was performed, based on individual and focus group patient interviews with 90 patients in five European countries.ResultsThe 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.ConclusionsPatients' 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.

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