The impact of a structured handover checklist for intraoperative staff shift changes on effective communication, OR team satisfaction, and patient safety: a pilot study

Abstract

Objective Handover without a structured format is prone to the omission of information and could be a potential risk to patient safety. We sought to determine the effect of a structured checklist on the quality of intraoperative change of shift handover between scrubs and circulars. Methods We conducted a control intervention study on operating room wards of two teaching hospitals from 20 Feb to 21 Nov 2020. This research was conducted in three stages as follows: assessing the current situation (as a group before the intervention), performing the intervention and evaluating the effect of using a checklist on handover quality after the intervention in two groups: with and without checklist. We examined the quality of handover between scrub and circular personnel in terms of handover duration and quality, omission of information and improvement in OR staff satisfaction. Results A total of 120 handovers were observed and evaluated. After intervention in the group using the checklist, the percentage of information omission in surgical report was decreased from 19.5 to 12.1% between scrubs (P < 0.00) and from 16.8 to 14.1% between circulars (P < 0.03). Also, in the role of scrub, the mean overall score of handover process quality was significantly higher after the intervention (x̄ = 7 ± 1.5) than before it (x̄ = 6.5 ± 0.9) (p < 0.02). In the role of circulating, despite the positive effect of overall score checklist, no significant difference was observed (p < 0.08). The use of checklist significantly increased the handover duration between scrubs (p < 0.03) and circulars (p < 0.00). The overall mean percentage of handover satisfaction increased from 67.5% before the intervention to 85.5% after the intervention (p < 0.00). Conclusion The implementation of a new structured handover checklist had a positive impact on improving the quality of communication between the surgical team, reducing the information omission rate and increasing the satisfaction.

Operating room organization and surgical performance: a systematic review

“…In response to this, Nasiri et al introduced a handover checklist, resulting in a notable decrease in information omission and an improvement in overall handover quality for scrubs. Although the checklist increased handover duration, it significantly enhanced overall satisfaction, emphasizing its positive influence on communication quality and team contentment within the surgical team [ 95 ]. Team familiarity could also improve post operative outcomes according to Awtry et al who conclude that higher surgeon-anesthesiologist familiarity in cardiac surgery teams correlated with lower rates of adverse outcomes, including 30-day mortality, 90-day mortality, composite morbidity, and the combined endpoint of 30-day mortality or composite morbidity [ 96 ].…”

The Effects of an Order-Assist Mobile Application on Pediatric Anesthesia Safety: An Observational Study

“…Recent research has demonstrated several methods that use a structured checklist or communication tool to prevent human error due to miscommunication in medical practice. Nasiri et al reported that implementing a structured handover checklist during intraoperative staff shift changes improved the quality of communication within the surgical team, lowered the information omission rate, and increased team satisfaction [20]. In addition, Randmaa et al stated that implementing a communication tool in anesthetic clinics enhanced staff members' perception of communication and safety climate and decreased the proportion of incident reports related to communication errors [21].…”

Development and Effectiveness of a Standardized Hand‐Off Program Using the SWITCH Tool for OR Nurses: A Randomized Controlled Trial

“…These categories relate to various items specific to the OR (eg, devices, personnel present, solutions) and provide the tools to increase the effectiveness of the surgical team members’ communication 11 . The use of SWITCH can have a positive effect on health care professionals’ satisfaction and patient safety because of the clear and precise communication tactics it promotes by providing specific communication content in the OR 12 . In South Korea, a standardized hand‐off tool has not yet been introduced for OR nurses.…”

“…Studies of health care professionals have reported that hand‐off satisfaction, 12,16 hand‐off self‐efficacy, 17 job performance, and communication competence improved as a result of standardized tools. Organization and professionalism among health care professionals are primary factors responsible for increases in hand‐off satisfaction 12 . The number of nurses who were satisfied with the information provided during hand off using SBAR increased from 34% to 41% 18 .…”

“…11 The use of SWITCH can have a positive effect on health care professionals' satisfaction and patient safety because of the clear and precise commu nication tactics it promotes by providing specific communi cation content in the OR. 12 In South Korea, a standardized hand-off tool has not yet been introduced for OR nurses. In a study, 4.8% to 7.2% of scrubbed persons were able to confidently perform the hand-off process with appro priate interpretation and explanation of the information.…”