Advantages and disadvantages of between unit hand-off policies in Iranian hospitals: a qualitative study.

Introduction: Currently in emergency department (ED) of educational medical centers of Iran there are generally two models for between unit hand-off process based on the time of transferring the responsibility (during stay vs. while departure). There is no comprehensive study available to compare the policies. Thus, the present qualitative study was designed to compare these two methods of hand-off via performing interviews by specialist physicians who involving the process in the hospitals to express the advantages and disadvantages of the two policies from their point of view. Methods: This qualitative study was done by using opinions of experts throughout 2015 and 2016. Interviews were performed using a one-on-one and in-depth semi-structured approach. Before asking the questions, the definitions of the two models of hand-off as well as the aims of the study were briefly explained to the interviewee. Thematic and content analysis strategies were used to identify core concepts and to develop categories. Qualitative content analytical approaches focus on analyzing both the explicit content of a text and the latent content that can be extrapolated from the text. Results: In the present study, a total of 25 individuals were interviewed. The mean age of the participants was 34 years and their mean working experience was 7 years. By analyzing the interviews performed, the results were categorized in four main themes including 'resident training', 'patient management in ED', 'quality and process of diagnosis and treatment of patients' and finally, 'satisfaction with the process among specialist'. Conclusion: Although the two methods have advantages and disadvantages, it is likely that during stay, model was more favorable than while departure model from the viewpoints of interviewees. However, it seems that choosing any of the methods depends on various situations such as workload, academic matters, availability of resources, etc.