TY - JOUR
T1 - The perioperative handoff protocol
T2 - Evaluating impacts on handoff defects and provider satisfaction in adult perianesthesia care units
AU - Petrovic, Michelle A.
AU - Aboumatar, Hanan
AU - Scholl, Adam T.
AU - Gill, Randeep S.
AU - Krenzischek, Dina A.
AU - Camp, Melissa S.
AU - Senger, Carolyn M.
AU - Deng, Yi
AU - Chang, Tracy Y.
AU - Xie, Yanjun
AU - Jurdi, Zahi R.
AU - Martinez, Elizabeth A.
N1 - Publisher Copyright:
© 2014 Elsevier Inc. All rights reserved.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Study Objective To evaluate a new perioperative handoff protocol in the adult perianesthesia care units (PACUs). Design Prospective, unblinded cross-sectional study. Setting Perianesthesia care unit in a tertiary care facility serving 55,000 patients annually. Patients One hundred three surgery patients. Interventions During a 4-week preintervention phase, 53 perioperative handoffs were observed, and data were collected daily by a trained observer. Educational sessions were conducted to train perioperative practitioners on the new protocol. Two weeks after implementation, 50 consecutive handoffs were observed, and practitioners were surveyed with the same methodology as in the preintervention phase. Measurements Type of information shared, type and duration of procedure, total duration of handoff, number and type of providers at the bedside, number of report interruptions, environmental distractions, and any other disruptive events. Observers also tracked technical/equipment problems to include malfunctioning or compromised operation of medical equipment, such as the cardiac monitor, transducer, oxygen tank, and pulse oximeter. Main Results A total of 103 handoffs were observed (53 preintervention and 50 postintervention). The mean number of defects per handoff decreased from 9.92 to 3.68 (P <.01). The mean number of missed information items from the surgery report decreased from 7.57 to 1.2 items per handoff and from 2.02 to 0.94 (P <.01) for the anesthesia report. Technical defects reported by unit nurses decreased from 0.34 to 0.10 (P =.04). Verbal reports delivered by surgeons increased from 21.2% to 83.3%. Although the mean duration of handoffs increased by 2 minutes (P =.01), the average time from patient arrival at PACU to handoff start was reduced by 1.5 minutes (P =.01). Satisfaction with the handoff improved significantly among PACU nurses. Conclusions The perioperative handoff protocol implementation was associated with improved information sharing and reduced handoff defects.
AB - Study Objective To evaluate a new perioperative handoff protocol in the adult perianesthesia care units (PACUs). Design Prospective, unblinded cross-sectional study. Setting Perianesthesia care unit in a tertiary care facility serving 55,000 patients annually. Patients One hundred three surgery patients. Interventions During a 4-week preintervention phase, 53 perioperative handoffs were observed, and data were collected daily by a trained observer. Educational sessions were conducted to train perioperative practitioners on the new protocol. Two weeks after implementation, 50 consecutive handoffs were observed, and practitioners were surveyed with the same methodology as in the preintervention phase. Measurements Type of information shared, type and duration of procedure, total duration of handoff, number and type of providers at the bedside, number of report interruptions, environmental distractions, and any other disruptive events. Observers also tracked technical/equipment problems to include malfunctioning or compromised operation of medical equipment, such as the cardiac monitor, transducer, oxygen tank, and pulse oximeter. Main Results A total of 103 handoffs were observed (53 preintervention and 50 postintervention). The mean number of defects per handoff decreased from 9.92 to 3.68 (P <.01). The mean number of missed information items from the surgery report decreased from 7.57 to 1.2 items per handoff and from 2.02 to 0.94 (P <.01) for the anesthesia report. Technical defects reported by unit nurses decreased from 0.34 to 0.10 (P =.04). Verbal reports delivered by surgeons increased from 21.2% to 83.3%. Although the mean duration of handoffs increased by 2 minutes (P =.01), the average time from patient arrival at PACU to handoff start was reduced by 1.5 minutes (P =.01). Satisfaction with the handoff improved significantly among PACU nurses. Conclusions The perioperative handoff protocol implementation was associated with improved information sharing and reduced handoff defects.
KW - Handoffs
KW - Handovers
KW - PACU
KW - Perioperative
KW - Transfers
KW - Transitions
UR - http://www.scopus.com/inward/record.url?scp=84924150144&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924150144&partnerID=8YFLogxK
U2 - 10.1016/j.jclinane.2014.09.007
DO - 10.1016/j.jclinane.2014.09.007
M3 - Article
C2 - 25541368
AN - SCOPUS:84924150144
SN - 0952-8180
VL - 27
SP - 111
EP - 119
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
IS - 2
ER -