Faculty Collaboration Database

Implementation of a standardized handoff protocol for post-operative admissions to the surgical intensive care unit. Am J Surg 2018 Jan;215(1):28-36

Date

08/22/2017

Pubmed ID

28823594

DOI

10.1016/j.amjsurg.2017.08.005

Scopus ID

2-s2.0-85027701066 (requires institutional sign-in at Scopus site)   25 Citations

Abstract

BACKGROUND: The transfer of critically ill patients from the operating room (OR) to the surgical intensive care unit (SICU) involves handoffs between multiple providers. Incomplete handoffs lead to poor communication, a major contributor to sentinel events. Our aim was to determine whether handoff standardization led to improvements in caregiver involvement and communication.

METHODS: A prospective intervention study was designed to observe thirty one patient handoffs from OR to SICU for 49 critical parameters including caregiver presence, peri-operative details, and time required to complete key steps. Following a six month implementation period, thirty one handoffs were observed to determine improvement.

RESULTS: A significant improvement in presence of physician providers including intensivists and surgeons was observed (p = 0.0004 and p < 0.0001, respectively). Critical details were communicated more consistently, including procedure performed (p = 0.0048), complications (p < 0.0001), difficult airways (p < 0.0001), ventilator settings (p < 0.0001) and pressor requirements (p = 0.0134). Conversely, handoff duration did not increase significantly (p = 0.22).

CONCLUSIONS: Implementation of a standardized protocol for handoffs between OR and SICU significantly improved caregiver involvement and reduced information omission without affecting provider time commitment.

Author List

Mukhopadhyay D, Wiggins-Dohlvik KC, MrDutt MM, Hamaker JS, Machen GL, Davis ML, Regner JL, Smith RW, Ciceri DP, Shake JG

MESH terms used to index this publication - Major topics in bold

Communication
Critical Care
Humans
Intensive Care Units
Interprofessional Relations
Patient Admission
Patient Care Team
Patient Handoff
Patient Safety
Postoperative Care
Practice Guidelines as Topic
Prospective Studies
Quality Improvement
Time Factors