Health Policy and Systems
Seungjae Cho, BSc
Medical student
Temerty Faculty of Medicine, University of Toronto
Toronto, Ontario, Canada
Eric Poon, MD, MHSc
Resident
Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto
Toronto, Ontario, Canada
Nancy Xi, MD
Hospitalist
Toronto Rehab Institute, University Health Network
Toronto, Ontario, Canada
E. Ali Bateman, MSc, MD, FRCPC (she/her/hers)
Physiatrist & Assistant Professor
St Joseph's Health Care London & Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Schulich School of Medicine & Dentistry, Western University
London, Ontario, Canada
Cynthia Chui, MI
Information Specialist
University Health Network
Toronto, Ontario, Canada
Aran Bains, BSc
Medical student
Schulich School of Medicine & Dentistry, University of Western Ontario
London, Ontario, Canada
Patrick Fangping Yao, MD
Resident
Physical Medicine & Rehabilitation, McMaster University
Hamilton, Ontario, Canada
Meiqi Guo, MD, MSc
Physiatrist and Brain Rehabilitation Program Medical Director
UHN-Toronto Rehab; University of Toronto Faculty of Medicine
Toronto, Ontario, Canada
Transitions from acute care to rehabilitation involve patients moving between two care environments with different personnel, cultures, and goals of care. Effective handover between medical providers is essential to ensure patient safety and optimal care. While individual studies have evaluated potential solutions to improve medical handovers, there has yet to be a comprehensive synthesis of the literature on how acute care to rehabilitation handovers can be optimized. The objective of this scoping review is to map the existing literature on strategies to improve physician-to-physician handover from acute care to rehabilitation.
Design:
A scoping review was conducted by following the Joanna Briggs Institute framework. Comprehensive searches were conducted in MEDLINE(R)ALL, Embase, APA PsycINFO, Cochrane Central, Emcare, CINAHL Ultimate, and Web of Science by a health sciences librarian. Eligible studies included qualitative, quantitative, and mixed-methods research describing strategies to improve handover for patients transitioning from acute care to rehabilitation. Screening and data extraction using the TIDieR framework were conducted in duplicate using Covidence systematic review software. Results were synthesized quantitatively and qualitatively.
Results:
Fifteen studies published between 2002 and 2024 were included. Most originated from the United States (93%) and focused on transitions from academic acute care hospitals to skilled nursing facilities (73%). Studied strategies for improving care transition included the use of video-conferencing to facilitate physician-to-physician handover, virtual collaborative rounding, and structured checklists for written handover. In addition, cultural interventions such as relationship building, bi-directional learning and eliminating perceived hierarchy between acute care and rehabilitation providers were shown in the literature as helpful for bridging communication gap between the two care settings.
Conclusion:
This review highlights the potential of both technical and cultural strategies of building relationships for improving handover from acute care to rehabilitation. Findings from this review will inform future quality improvement initiatives on improving handover from acute care to rehabilitation.
