Pilot Implementation of a Perioperative Protocol to Guide Operating Room–to–Intensive Care Unit Patient Handoffs

Petrović, M; Aboumatar, Hanan; Baumgartner, William A.; Ulatowski, John A.; Moyer, Jenny; Chang, Tracy Y.; Camp, Melissa; Kowalski, J.; Senger, Carolyn M.; Martinez, Elizabeth A.

doi:10.1053/j.jvca.2011.07.009

Cited by 113 publications

(88 citation statements)

References 17 publications

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“…Still, family and patient satisfaction significantly increased during the implementation period, suggesting that their formal inclusion in a standardized process is associated with enhanced satisfaction adjunctive to a culture of family centeredness. Similar to previous single-site studies, 18 we also found that provider satisfaction was not compromised after the implementation of a standard handoff process.…”

Section: Figuresupporting

confidence: 89%

“…6,9,18,19 However, these studies did not specifically measure the potential benefit on the efficiency of care delivery often associated with standardization in high-reliability systems. 20 A small number of studies have measured handover time as a balancing metric; these 5 …”

Section: Discussionmentioning

confidence: 99%

“…9,18,21 The coordination of unit teams with varying patient care agendas around a patient transfer from the CVICU to ACU introduces unique challenges in productivity and efficiency. Improved efficiency adds a new dimension to the value of standardized handover protocols, which have already been linked to better patient outcomes and provider satisfaction.…”

Section: Figurementioning

confidence: 99%

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Changes in Efficiency and Safety Culture After Integration of an I-PASS–Supported Handoff Process

Sheth

Kipps

et al. 2016

Pediatrics

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Ineffective handoff communication is a recognized patient safety risk in health care. In response, quality improvement experts have developed methods for structuring and standardizing transfer processes and handoff communication. These have included mnemonics for use during handovers, scripts or worksheets for the standardization of information conveyed, and the minimization of interruptions and distractions during verbal handovers. [1][2][3][4] Recent studies have also reported successfully leveraging multidisciplinary team strategies and workflow adjustments, such as reducing nighttime transfers from the ICU. 5 Most notably, the implementation of the I-PASS (illness severity, patient summary, action list, situation awareness and contingency plans, and synthesis by receiver)-supported handoff bundle studied with resident-to-resident handoffs has abstract BACKGROUND AND OBJECTIVES: Recent publications have shown improved outcomes associated with resident-to-resident handoff processes. However, the implementation of similar handoff processes for patients moving between units and teams with expansive responsibilities presents unique challenges. We sought to determine the impact of a multidisciplinary standardized handoff process on efficiency, safety culture, and satisfaction.

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Section: Figuresupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

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Changes in Efficiency and Safety Culture After Integration of an I-PASS–Supported Handoff Process

Sheth

Kipps

et al. 2016

Pediatrics

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“…This increase is consistent with previous single-site studies that have successfully implemented a standard handoff process. 26 The present study did not directly measure patient harm but rathera predicate marker of harm: handoff-related care failures (essentially handoff errors). High reliability organization theory contends that errors result from process failureswhicheventuallyleadtoharm.…”

Section: Figurementioning

confidence: 97%

Decreasing Handoff-Related Care Failures in Children’s Hospitals

Bigham¹,

Logsdon

Manicone³

et al. 2014

Pediatrics

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BACKGROUND AND OBJECTIVE: Patient handoffs in health care require transfer of information, responsibility, and authority between providers. Suboptimal patient handoffs pose a serious safety risk. Studies demonstrating the impact of improved patient handoffs on care failures are lacking. The primary objective of this study was to evaluate the effect of a multihospital collaborative designed to decrease handoff-related care failures.METHODS: Twenty-three children' s hospitals participated in a quality improvement collaborative aimed at reducing handoff-related care failures. The improvement was guided by evidence-based recommendations regarding handoff intent and content, standardized handoff tools/methods, and clear transition of responsibility. Hospitals tailored handoff elements to locally important handoff types. Handoff-related care failures were compared between baseline and 3 intervention periods. Secondary outcomes measured compliance to specific change package elements and balancing measure of staff satisfaction. RESULTS:Twenty-three children' s hospitals evaluated 7864 handoffs over the 12-month study period. Handoff-related care failures decreased from baseline (25.8%) to the final intervention period (7.9%) (P , .05). Significant improvement was observed in every handoff type studied. Compliance to change package elements improved (achieving a common understanding about the patient from 86% to 96% [P , .05]; clear transition of responsibility from 92% to 96% [P , .05]; and minimized interruptions and distractions from 84% to 90% [P , .05]) as did overall satisfaction with the handoff (from 55% to 70% [P , .05]).CONCLUSIONS: Implementation of a standardized evidence-based handoff process across 23 children' s hospitals resulted in a significant decrease in handoff-related care failures, observed over all handoff types. Compliance to critical components of the handoff process improved, as did provider satisfaction. Pediatrics 2014;134: e572-e579 AUTHORS:

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“…Die Methode wird daher als eine Hilfestellung insbesondere für jüngere Kollegen empfohlen. Auch der Einsatz von Übergabechecklisten wird als erfolgreich, d. h. fehlerreduzierend, beschrieben[22,30].…”

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Kommunikation in der Intensivmedizin

Heer

Kluge

2012

Med Klin Intensivmed Notfmed

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Communication plays a crucial role in the intensive care unit. Posttraumatic stress syndromes develop in a significant number of patients and their relatives after being in an intensive care unit. The syndromes may persist for several years. Regular open and empathic communication with patients and family members reduces the frequency and severity of the disease. Among the physicians and nurses in the intensive care unit, there is a high prevalence of burnout syndrome. The precipitating factors are mostly conflicts within the working staff, work overload and end-of-life situations. Working team communication reduces the rate of exhaustion syndromes. Rounds of discussions among the work groups are the basis for a healthy team structure. Inadequate communication, e.g., during emergencies or shift change, endangers the safety of patients and in the worst case, results in treatment mistakes. Measures for improved communication in the intensive care unit should always be implemented.

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Pilot Implementation of a Perioperative Protocol to Guide Operating Room–to–Intensive Care Unit Patient Handoffs

Cited by 113 publications

References 17 publications

Changes in Efficiency and Safety Culture After Integration of an I-PASS–Supported Handoff Process

Changes in Efficiency and Safety Culture After Integration of an I-PASS–Supported Handoff Process

Decreasing Handoff-Related Care Failures in Children’s Hospitals

Kommunikation in der Intensivmedizin

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