Handoffs in the Intensive Care Unit

Hochman, Beth; Barry, Mark; Lane‐Fall, Meghan; Allen, Steven R.; Holena, Daniel N.; Smith, Brian P.; Kaplan, Lewis J.; Pascual, José L.

doi:10.1177/1062860615617238

Cited by 12 publications

(14 citation statements)

References 29 publications

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“…23,24 We recently evaluated OR-to-ICU handoffs during the weekdays versus nights and weekends using study personnel present within the patient’s room, who evaluated the handoffs in full view of the clinical providers. In that setting, we found significantly better transmitter communication scores on nights and weekends compared with weekdays; however, a Hawthorne effect may have been present.…”

Section: Discussionmentioning

confidence: 99%

“…In that setting, we found significantly better transmitter communication scores on nights and weekends compared with weekdays; however, a Hawthorne effect may have been present. 23 The current study may have gauged handoff practices more accurately, as the evaluation was carried out essentially without the transmitters or receivers being aware that they were being evaluated. Another study of change-of- shift handoffs in obstetrical inpatients found that resident handoffs were better in the mornings than evenings, while the opposite was true of the nursing handoffs.…”

Section: Discussionmentioning

confidence: 99%

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Leveraging Telemedicine Infrastructure to Monitor Quality of Operating Room to Intensive Care Unit Handoffs

et al. 2017

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Purpose To analyze in-room video recordings of operating room (OR) to intensive care unit (ICU) handoffs to determine tempo and quality of team interactions on nights and weekends compared with weekdays, and to demonstrate how existing telemedicine technology can be used to evaluate handoffs. Method This prospective observational study of OR-to-ICU bedside handoffs was conducted in the surgical ICU of the Hospital of the University of Pennsylvania in July 2014–January 2015. Handoff video recordings were obtained for quality improvement purposes using existing telemedicine cameras. Evaluators used adapted validated in-person assessment measures to analyze basic characteristics and quality measures (timing, report types, report duration, presence of physical exam, teamwork skills, engagement, report delivery skills, listening skills, interruptions, unprofessional comments or actions). Results Sixteen weekday and 16 night and weekend handoffs were compared. There were no significant differences in basic characteristics. Most quality measures were similar on weekdays compared with nights and weekends. Surgeons demonstrated better report delivery skills and engagement on nights and weekends (P = .002 and P = .04, respectively), whereas OR anesthesiologists’ scores were similar during both time frames. Conclusions This study presents a novel approach of assessing handoff quality in OR-to-ICU handoffs using an existing telemedicine infrastructure. Using this approach, quality measures of night and weekend handoffs were found to be no worse— and sometimes better—than those during weekdays. Video analysis may emerge as an ideal unobtrusive quality improvement methodology to monitor handoffs and improve education and compliance with institutional handoff policies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Leveraging Telemedicine Infrastructure to Monitor Quality of Operating Room to Intensive Care Unit Handoffs

et al. 2017

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“…There are more than 20 published studies addressing the transition of patients from the OR to the ICU, with at least 10 published in the last 5 years [15][16][17][18][19][20][21][22][23][24][25]. This particular transition is interesting for multiple reasons.…”

Section: Or-to-icu Handoffsmentioning

confidence: 99%

Transitions of Care in the Perioperative Period

Becker

Lane‐Fall

2017

Curr Anesthesiol Rep

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Purpose of Review The purpose of this article is to summarize the evolving literature concerning perioperative handoffs for surgical patients. Recent Findings Perioperative transitions of care are high-risk events with the opportunity for patient harm. Recognition of this risk has led to increased scrutiny of handoffs occurring throughout the perioperative care continuum. Though limited, previous literature has focused on the use of checklists as a strategy to increase handoff reliability. More recent literature suggests that broader, process-driven interventions may be more effective in addressing the multiple factors that contribute to the success of patient handoffs. Further, recent studies have begun to address the sustainability of such interventions. Summary Handoffs are complex, error-prone patient care events. Handoff process standardization (including, but not solely consisting of checklist use) is a promising, evidencebased strategy that has been shown to improve communication and mitigate harm to patients receiving care in perioperative settings.

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“…A nursing handover is a vital element in the continuity of care [ 37 ]. Transitions in care are notable periods of vulnerability in a patients’ treatment journey [ 38 ]. Transferring responsibility for a patient’s care to another health care professional increases the chances of an error occurring, especially if key information is communicated inaccurately and inefficiently [ 39 ].…”

Section: Introductionmentioning

confidence: 99%

An Evidence-Based, Nursing Handover Standard for a Multisite Public Hospital in Switzerland: Web-Based, Modified Delphi Study

Tacchini-Jacquier¹,

Hertzog²,

Ambord³

et al. 2020

JMIR Nursing

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Background Ineffective communication procedures create openings for errors when health care professionals fail to transfer complete, consistent information. Deficient or absent clinical handovers, or failures to transfer information, responsibility, and accountability, can have severe consequences for hospitalized patients. Clinical handovers are practiced every day, in many ways, in all institutional health care settings. Objective This study aimed to design an evidence-based, nursing handover standard for inpatients for use at shift changes or internal transfers between hospital wards. Methods We carried out a modified, multiround, web-based, Delphi data collection survey of an anonymized panel sample of 264 nurse experts working at a multisite public hospital in Switzerland. Each survey round was built on responses from the previous one. The surveys ended with a focus group discussion consisting of a randomly selected panel of participants to explain why items for the evidence-based clinical nursing handover standard were selected or not selected. Items had to achieve a consensus of ≥70% for selection and inclusion. Results The study presents the items selected by consensus for an evidence-based nursing handover standard for inpatients for use at shift changes or internal transfers. It also presents the reasons why survey items were or were not included. Conclusions This modified Delphi survey method enabled us to develop a consensus- and evidence-based nursing handover standard now being trialed at shift changes and the internal transfers of inpatients at our multisite public hospital in Switzerland.

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Handoffs in the Intensive Care Unit

Cited by 12 publications

References 29 publications

Leveraging Telemedicine Infrastructure to Monitor Quality of Operating Room to Intensive Care Unit Handoffs

Leveraging Telemedicine Infrastructure to Monitor Quality of Operating Room to Intensive Care Unit Handoffs

Transitions of Care in the Perioperative Period

An Evidence-Based, Nursing Handover Standard for a Multisite Public Hospital in Switzerland: Web-Based, Modified Delphi Study

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