Evaluation of the Inter-Hospital Patient Transfer Form (Health 946): A Perception Study of Medical Officers in Base Hospital Kalmunai North, Sri Lanka

Abstract

Background: Effective communication during patient handovers is critical to ensuring continuity of care and patient safety. International evidence consistently identifies communication failures as a leading contributor to preventable adverse events. In Sri Lanka, Health Form 946 (H946) has served as the nationally mandated document for inter-hospital patient transfers for several decades. However, its alignment with contemporary structured communication standards has not been systematically evaluated.Objective: This study aimed to assess the perceptions of Medical Officers (MOs) regarding the adequacy of H946 for supporting safe and effective inter-hospital patient transfers, focusing on information content, layout, ease of use, and implications for clinical safety.Methods: A descriptive cross-sectional study was conducted in September 2025 at Base Hospital Kalmunai North (BHKN). All currently employed MOs were included. Data was collected using a structured, validated, self-administered questionnaire comprising Likert-scale and open-ended questions across four domains: demographics and usage, information content, layout and usability, and key recommendations.Results: Seventy-eight percent of MOs reported using H946 two to three times per week. While 93% agreed that the form adequately captures basic patient identification, only 13% felt it clearly prompts documentation of the precise reason for transfer, and 91% reported insufficient space for a comprehensive clinical summary. Ninety-seven percent strongly disagreed that the form mandates inclusion of critical safety information such as allergies and current medications, and 92% found it ineffective in preventing documentation errors or omissions. Eighty-one percent supported integration of a structured checklist, and 77% believed a redesigned form would reduce patient risk during transfer.Conclusion: The findings demonstrate that while H946 fulfils its administrative role, it does not adequately support the structured clinical communication required for safe inter-hospital patient handover. A revised form incorporating internationally recommended structured handover elements would represent a meaningful, system-level patient safety improvement.