Review article: Current literature on surgical checklists and handoff tools and application for orthopaedic surgery

Sleiman, Bilal; Sayeed, Zain; Padela, Muhammad T.; Padela, Abdurrahman F.; Bobba, Vamsy; Yassir, Walid; Frush, Todd; Saleh, Khaled J.

doi:10.1016/j.jor.2018.12.006

Cited by 8 publications

(6 citation statements)

References 22 publications

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“…Within orthopaedics, previous efforts to improve communication and patient care have centered around preoperative and postoperative checklists. 12,13 In contrast, Gagnier et al 14 developed a handoff tool for orthopaedic trauma residents and evaluated its effect on adverse events. After interdisciplinary design and pilot testing, the handoff tool was implemented and data were collected for 127 patients.…”

Section: Discussionmentioning

confidence: 99%

OrthoPass: Long-term Outcomes following Implementation of an Orthopaedic Patient Handoff Template

Lightsey,

Yeung,

Rossi

et al. 2023

JAAOS Glob Res Rev

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Standardized handoff tools improve communication and patient care; however, their widespread use in surgical fields is lacking. OrthoPass, an orthopaedic adaptation of I-PASS, was developed in 2019 to address handoff concerns and demonstrated sustained improvements across multiple handoff domains over an 18-month period. We sought to characterize the longitudinal effect and sustainability of OrthoPass within a single large residency program 3.5 years after its implementation. This mixed methods study involved electronic handoff review for quality domains in addition to survey distribution and evaluation. We conducted comparative analyses of handoff adherence and survey questions as well as a thematic analysis of provider-free responses. We evaluated 146 electronic handoffs orthopaedic residents, fellows, and advanced practice providers 3.5 years after OrthoPass implementation. Compared with 18-month levels, adherence was sustained across five of nine handoff domains and was markedly improved in two domains. Furthermore, provider valuations of OrthoPass improved regarding promoting communication and patient safety (83% versus 70%) and avoiding patient errors and near misses (72% versus 60%). These improvements were further substantiated by positive trends in Agency for Healthcare Research and Quality Surveys on Patient Safety Culture hospital survey data. Thematic analysis of free responses shared by 37 providers (42%) generated favorable, unfavorable, and balanced themes further contextualized by subthemes. At 3.5 years after its introduction, OrthoPass continues to improve patient handoff quality and to support provider notions of patient safety. Although providers acknowledged the benefits of this electronic handoff tool, they also shared unique insights into several drawbacks. This feedback will inform ongoing efforts to improve OrthoPass.

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Section: Discussionmentioning

confidence: 99%

OrthoPass: Long-term Outcomes following Implementation of an Orthopaedic Patient Handoff Template

Lightsey,

Yeung,

Rossi

et al. 2023

JAAOS Glob Res Rev

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show abstract

“…Prior efforts to improve patient handoffs in orthopaedics have described the development of handoff criteria de novo through surveys and focus groups. Sleiman et al 15 conducted a review of current literature on surgical checklists and handoff tools for orthopaedic surgery. They emphasized the potential for checklists to improve cost-effectiveness and reduce both mortality and complications, but they noted a lack of orthopaedic-specific tools.…”

Section: Discussionmentioning

confidence: 99%

Sustained Improvement in Quality of Patient Handoffs After Orthopaedic Surgery I-PASS Intervention

et al. 2022

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Purpose: The I-PASS tool has been shown to decrease medical errors in patient handoffs in nonorthopaedic surgery fields. We prospectively studied the implementation of a version of this handoff tool modified for orthopaedic surgery patients in an academic practice at two level I trauma centers. Methods: This was a prospective study of a multicenter handoff improvement program. Handoffs were evaluated preintervention and at 1, 6, 9, and 18 months postintervention for key data elements defined by I-PASS. Rates of adverse clinical outcomes were compared before and after the handoff intervention. Results: Seven hundred five electronic patient handoffs were analyzed. From preintervention to the 18-month time point, notable improvement was observed in 8 of 9 targeted quality elements. In Poisson regression analysis, adherence to the standardized handoff format was sustained at markedly improved levels throughout all postintervention time points. No statistically significant differences were observed between rates of 30day readmission, 90-day readmission, urinary tract infection, pulmonary embolism/deep vein thrombosis, surgical site infection, or delirium before and after the intervention. Conclusion: Introduction of an orthopaedic-specific I-PASS tool produced sustained adherence from a group of over 50 orthopaedic providers. Objective quality of handoffs improved markedly as defined by the I-PASS standard, and 86% of the providers supported the ongoing use of the tool. Despite the improvement in handoff quality, we were unable to demonstrate a notable change in measured clinical outcomes. Methods for the development and implementation of the orthopaedicspecific I-PASS tool are described. Orthopaedic residency programs should consider using a version of I-PASS to standardize care. Medical errors are a leading cause of death among Americans. 1 Transitions of patient care from one provider or team to another, also known as "handoffs," are a risk factor for medical error. 2,3 Interventions to improve and standardize communication during handoffs

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“…Examples in medicine include the use of surgical safety checklists and standardized order sets. 26 , 27 The previous literature has shown that carefully developed and well-implemented checklists are effective in error prevention, standardization of management, and performance improvement in patient care. 23 – 25 Clinical guidelines and best practices in stroke have been established and published by several professional organizations worldwide.…”

Section: Special Projectsmentioning

confidence: 99%

The World Stroke Academy: A World Stroke Organization global pathway to improve knowledge in stroke care

Saposnik

Galanos²,

et al. 2022

International Journal of Stroke

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The World Stroke Academy (WSA) is the educational platform of the WSO. It facilitates educational activities (e.g. webinars, eLearning modules) and supports the WSO mission by providing high-quality stroke education to healthcare professionals. It provides evidence-based educational materials in a variety of formats to meet the needs of the WSO membership. This article introduces the WSA, its core activities, and outlines how to access the many educational resources it offers. The WSA offers high-quality peer-reviewed stroke education material and uses outcome metrics to assess and improve the quality of medical training of healthcare professionals. This article also highlights the importance of identifying knowledge and knowledge-to-action gaps through the creation of special projects and initiatives. It describes three areas in which the WSA has carried out recent educational initiatives namely: Life after stroke., women in stroke and Stroke Checklist/Pre-printed stroke orders. WSA material is freely available, and we would encourage the global stroke community to use, and contribute to, its resources.

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Review article: Current literature on surgical checklists and handoff tools and application for orthopaedic surgery

Cited by 8 publications

References 22 publications

OrthoPass: Long-term Outcomes following Implementation of an Orthopaedic Patient Handoff Template

OrthoPass: Long-term Outcomes following Implementation of an Orthopaedic Patient Handoff Template

Sustained Improvement in Quality of Patient Handoffs After Orthopaedic Surgery I-PASS Intervention

The World Stroke Academy: A World Stroke Organization global pathway to improve knowledge in stroke care

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