Recommendation 14: Standardised structured handovers should be used in all areas of clinical care.

Recommendation 15: Development of checklists appropriate to the clinical setting and workload should be considered as an aide memoire when needed alongside a structured handover.

Handover is universally accepted as best practice and is recommended as such by international bodies such as the World Health Organization.²⁸ Most Scottish healthcare settings already use some form of a formal handover tool and their use is encouraged in the interest of patient safety. These can be used within specific care settings or for transitions between care settings, such as between paramedic and emergency medicine staff on arrival at hospital.

The evidence reviewed (all from hospital settings) does not robustly support structured handovers, with no impact on defined outcomes such as mortality reported, but it does indicate that, overall, handovers are a positive aspect of care and that structured handovers improve communication in terms of the quality and quantity of information handed over.^{29, 30, 31} Theoretically, harm could arise from a poor-quality or excessively long handover. There was no evidence on the use of structured handovers in community settings, and none of the studies involved patient satisfaction or feedback as an outcome.

Despite this lack of clear evidence of benefit, the group considered the use of structured handover to be best practice in all care settings and between care settings.