An Electronic Checklist Improves Transfer and Retention of Critical Information at Intraoperative Handoff of Care

Agarwala, Aalok V.; Firth, Paul G.; Albrecht, Meredith A.; Warren, Lisa; Musch, Guido

doi:10.1213/ane.0000000000000506

Cited by 71 publications

(70 citation statements)

References 28 publications

(40 reference statements)

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“…However, in common with previous findings, 11,13 our study showed handover times of 2 to 3 min which were not prolonged by the implementation of the handover training and display of the checklist. Because a significant number of healthcare providers in our study were concerned about the time required for using the handover checklists, and since this may have been one of the factors explaining why not everybody adopted the protocol, it is important to share this evidence with staff in the hope that this will increase utilisation.…”

Section: Discussionsupporting

confidence: 92%

“…Because a significant number of healthcare providers in our study were concerned about the time required for using the handover checklists, and since this may have been one of the factors explaining why not everybody adopted the protocol, it is important to share this evidence with staff in the hope that this will increase utilisation. The literature 11,12,14–16 shows that successfully implementing a checklist protocol can improve satisfaction, and we found the same.…”

Section: Discussionsupporting

confidence: 75%

“…Although Boat and Spaeth 12 showed 100% participation 2 months after their checklist implementation, Agarwala et al 11 checklist use was only 60% at 3 months and 74% at 8 months. Changing professional practice is difficult and takes significant time and effort; in our study, only 30% of the anaesthesia providers said they had fully integrated the checklist into their daily practice at 3 months.…”

Section: Discussionmentioning

confidence: 95%

“…vasopressors from 44 to 85%, antibiotics from 63 to 97%, postoperative plans from 43 to 92%). 11 Likewise, Boat and Spaeth 12 found that a paediatric handover checklist significantly improved the quality of patient handoff in the operating room (from 20 to 100% at 3 months), and Starmer et al 13 also observed an increase in the number of complete handovers as well as a decrease in errors during handovers made by paediatric residents using their checklist bundle (Illness severity, Patient summary, Action list, Situation awareness and contingency plans and Synthesis by receiver).…”

Section: Discussionmentioning

confidence: 98%

“…11 showed poor handover quality at baseline and were able to improve the communication of a number of important items significantly after implementation of a checklist (e.g. vasopressors from 44 to 85%, antibiotics from 63 to 97%, postoperative plans from 43 to 92%).…”

Section: Discussionmentioning

confidence: 98%

See 4 more Smart Citations

Training in intraoperative handover and display of a checklist improve communication during transfer of care

Jullia

Tronet

Fraumar

et al. 2017

European Journal of Anaesthesiology

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BACKGROUNDHandovers during anaesthesia are common, and failures in communication may lead to morbidity and mortality.OBJECTIVESWe hypothesised that intraoperative handover training and display of a checklist would improve communication during anaesthesia care transition in the operating room.DESIGNInterventional cohort study.SETTINGSingle-centre tertiary care university hospital.PARTICIPANTSA total of 204 random observations of handovers between anaesthesia providers (residents and nurse anaesthetists) over a 6-month period in 2016.INTERVENTIONTwo geographically different hospital sites were studied simultaneously (same observations, but no training/checklist at the control site): first a 2-week ‘baseline’ observation period; then handover training and display of checklists in each operating room (at the intervention site only) followed by an ‘immediate’ second and finally a third (3 months later) observation period.MAIN OUTCOME MEASURESA 22-item checklist was created by a modified DELPHI method and a checklist score calculated for each handover by adding the individual scores for each item as follows: −1, if error in communicating item; 0, unreported item; 0.5, if partly communicated item; 1, if correctly communicated item.RESULTSBefore training and display of the checklist, the scores in the interventional and the control groups were similar. There was no improvement in the control group's scores over the three observation periods. In the interventional group, the mean (95% confidence interval) score increased by 43% [baseline 7.6 (6.7 to 8.4) n = 42; ‘immediate’ 10.9 (9.4 to 12.4) n = 27, P < 0.001]. This improvement persisted at 3 months without an increase in the mean duration of handovers.CONCLUSIONIntraoperative handover training and display of a checklist in the operating room improved the checklist score for intraoperative transfer of care in anaesthesia.

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Section: Discussionsupporting

confidence: 92%