Introduction: “Hand-off” is used to describe the transfer of patients’ care from one physician to another while transitioning between call shifts. In neurosurgery, the complexity and rapid course of deterioration for variation pathologies leads to a significant dependence on thorough and efficient hand-off techniques. However, a lack of standardization leads to incomplete continuity of care. The goal of this review is to summarize the pre-existing research conducted on hand-off practices across residency programs in the United States, and highlight the commonalities that constitute optimal hand-offs in neurosurgery.
Methods: A systematic search strategy was implemented using Pubmed, Scopus, and Web of Science to query articles related to patient hand-off protocols in neurosurgery. Prior reviews or articles that didn’t fully describe their process were excluded. The hand-off practices and results of the remaining articles are covered in this paper.
Results: Eleven articles were included at the end of the screening process. It was reported that patients requiring a hand-off during their hospital stay, on average, stayed 2 days longer than those that didn’t. While one study addressed follow-up time between hand-offs and seeing the patient, a larger focus was on increasing standardization of hand-offs and documentation (9/11), formal training and supervision by seniors (3/11), and eliminating distractions during hand-offs and protected time (2/11). These practices were found to reduce hand-off times and the number of adverse events following hand-offs.
Conclusion : The most addressed concerns with neurosurgical hand-offs revolved around standardization, observation, and dedicated time. The findings in this review hold important implications for the future of clinical practice and training in the niche topic of neurosurgical hand-off practices, and highlights the need for continued research to address any existing gaps within these practices to ensure the quality, safety, and continuity of patient care during transfers of service.
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