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Background: Standardised handoff protocols have become necessary patient safety tools in the perioperative venue. In this study, the authors took a validated standardised perioperative handoff protocol and implemented it into their institution to improve the perioperative handoff communications from the cardiac operating theatres to the ICU. Methods: This was a prospective, unblinded cross-sectional study. During a 6-week pre-intervention phase, 30 perioperative handoffs were observed and data were collected. Then a new structured hand-off protocol was implemented for one month, which focused on training all participating healthcare providers. This was followed by a post-intervention audit consisting of 30 operating room theatre-to-ICU handoffs using the same methodology as the pre-intervention period. Results: Overall attendance significantly increased from 20 to 86.7%. The percentage of parallel conversations decreased from 100% pre-intervention to 60% post-intervention (p < 0.0001). The mean number of interruptions of the anaesthesiology handoff report decreased from 3.37 to 0.77 (p < 0.0001) and of the surgery report from 1.84 to 0.27 (p < 0.0001). Information-sharing scores improved among all handoff attendees with the Overall Information Sharing Score (OISS) increasing from 51.47 to 88.24% (p < 0.0001). Conclusions: The implementation of a perioperative handoff protocol resulted in a drastic improvement in attendance, decrease in the number of interruptions, and improved information sharing. Future research should focus on patient-specific outcomes.

Disruptive behavior is known to produce a wide range of negative effects in healthcare, such as impacting patient safety, lowering employee morale, and decreasing employee retention. Healthcare organizations have worked towards eliminating disruptive behavior; however, despite countless interventions, the issue continues to be a problem today. Why then does the issue of disruptive behavior persist? We argue that one reason is the multiple ways disruptive behavior can be described, henceforth defined as the "plurality of terms", which can make it difficult to collect relevant data by doing a simple literature search. Hence, we believe having a single definition for “disruptive behavior” will improve the meta-analysis on disruptive behavior research.

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The psychoactive substance cannabis is the most-commonly used drug around the world, and its use is becoming more prevalent globally. Additionally, it is becoming available in an increasing variety of forms. As such, it is imperative that perioperative practitioners have an understanding of the drug, its effects, and its implications in perioperative care. There is currently a lack of a standardised approach to a patient who uses cannabis, and prospective studies prove difficult given the current legal status of cannabis. This literature review seeks to provide information regarding cannabis and its use. Specifically, we explore the systemic effects of marijuana as well as perioperative and anaesthetic implications so that safer, more effective care may be administered.