## 4 Discussion
None of the three articles contemplates the standardization of communication in any of its domains or items [24; 29; 31]. Nevertheless, the totality of the literature ensures that the standardization of communication during the transfer is the best method of information transfer in addition to being associated with reduced errors and improved patient safety [5; 12; 13; 18; 33; 34; 36; 37]. The three studies [24; 29; 31] evaluated the content of the handover using differing items and factors. This was probably due to the lack of consensus on handover procedures in urgent and emergency care [14; 19]. It is essential that communication between two critical patient care teams is clear, specific, and concise [5; 38], which reinforces the need for precision in content assessment during handoffs. Other factors highlighted in the evaluation of the handovers by [PERSON] et al. [24] were efficiency and satisfaction. For [PERSON] [24], efficiency was represented by the mean handover durations determined by the initial time-out called by the emissor healthcare team and the cessation of handover discussion between providers. The efficiency of the handover was evaluated using a Likert scale, where the highest score was associated with a rapid handover [24]. However, we have not found a definition of an effective handover or the association of time spent on handover with efficacy. We also did not find out how much time should ideally be spent on a handover. Furthermore, while [PERSON] et al. [24] assessed overall satisfaction with the handover, reporting low/high responses [24], there was no clear definition of satisfaction or of what constitutes a successful handover [37; 39]. On the other hand, [PERSON] et al. [24] scored the general satisfaction of the handover using a five-point Likert scale, in which 1 expresses strong disagreement and 5 strong agreement in receiving a satisfactory handoff. AlthoughYoung [31] does not consider the future treatment administered to the patient once received by the new care team, [PERSON] [24] and [PERSON] [29] established a plan for future care to guide the receiving team on the subsequent treatment of the patient. [PERSON] et al. [24] analyzed this through the item \"anticipatory guidance\", while [PERSON] et al. [29] identified it as \"care orientation\". Additionally, both studies [24, 29] also considered the care offered to the patient during their treatment. [PERSON] et al. [24] differentiated between pre-and post-handover care, assessing actions during transport, and the post-admission care plan. [PERSON] et al. [29] also considered an alternate plan and the identification of outstanding tasks for the patient's receiving team. [PERSON] et al. [29] included the family of the patients in the evaluation of the handover. In particular, they considered the issues discussed with the patient and their family and the conflicts that may arise from them. Experts in the transfer of information confirmed that the ideal emergency handover involves healthcare professionals, patients, and relatives [40]. Involving patients and relatives in the process provides an opportunity to clarify unclear information and allows them to contribute additional information [40]. This approach decreases adverse events, improves communication, and enhances the continuity of patient care [40]. It is also worth noting that the tool in [PERSON] et al. [24] was validated only in critically ill pediatric patients and, although the scope of the study may be similar, its application in critically ill adult patients needs to be further explored. The evaluation of handovers [31] through the calculation of the cognitive load of the people involved in the process, as proposed by [PERSON] et al. [31], is an innovative and novel approach. The application of CLIH [31] makes it possible to identify practices and strategies that improve learning, thus it would be interesting to take this into account in the development of new protocols for the handover of critical patients to help reduce some of the errors typical to the practice.