Handoff checklists improve the reliability of patient handoffs in the operating room and postanesthesia care unit

Summary Background Ineffective communications among healthcare providers are common and increases the risk of medical errors. During the perioperative period, multiple handoffs occur within a short period of time, and failure to convey important patient information can compromise safety. We used qua...

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Veröffentlicht in:Pediatric anesthesia 2013-07, Vol.23 (7), p.647-654
Hauptverfasser: Boat, Anne C., Spaeth, James P.
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container_title Pediatric anesthesia
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creator Boat, Anne C.
Spaeth, James P.
description Summary Background Ineffective communications among healthcare providers are common and increases the risk of medical errors. During the perioperative period, multiple handoffs occur within a short period of time, and failure to convey important patient information can compromise safety. We used quality improvement methodology to improve the reliability of our handoffs in the operating room and postanesthesia care unit (PACU). Methods Two quality improvement teams were developed to focus on the intraoperative and postanesthesia handoff processes. Key driver diagrams and ‘smart aims’ were developed for each process based on feedback from anesthesia and nursing staff, and handoff checklists were developed and revised using multiple plan‐do‐study‐act cycles. Data on the reliability of the handoff processes were obtained prior to initiation of the projects and throughout the 6‐month project period. Results The reliability of intraoperative anesthesia handoffs improved from 20% to 100% with use of the intraoperative handoff checklist. Similarly, with the introduction of a standardized PACU checklist, the reliability of PACU handoffs improved from 59% to greater than 90%. Conclusion We utilized quality improvement methodology to develop and implement standardized checklists for handoffs of care in the operating room and PACU. Acceptance of and adherence to the standardized handoff protocols dramatically increased the quality and reliability of our handoff process.
doi_str_mv 10.1111/pan.12199
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During the perioperative period, multiple handoffs occur within a short period of time, and failure to convey important patient information can compromise safety. We used quality improvement methodology to improve the reliability of our handoffs in the operating room and postanesthesia care unit (PACU). Methods Two quality improvement teams were developed to focus on the intraoperative and postanesthesia handoff processes. Key driver diagrams and ‘smart aims’ were developed for each process based on feedback from anesthesia and nursing staff, and handoff checklists were developed and revised using multiple plan‐do‐study‐act cycles. Data on the reliability of the handoff processes were obtained prior to initiation of the projects and throughout the 6‐month project period. Results The reliability of intraoperative anesthesia handoffs improved from 20% to 100% with use of the intraoperative handoff checklist. Similarly, with the introduction of a standardized PACU checklist, the reliability of PACU handoffs improved from 59% to greater than 90%. Conclusion We utilized quality improvement methodology to develop and implement standardized checklists for handoffs of care in the operating room and PACU. Acceptance of and adherence to the standardized handoff protocols dramatically increased the quality and reliability of our handoff process.</description><identifier>ISSN: 1155-5645</identifier><identifier>EISSN: 1460-9592</identifier><identifier>DOI: 10.1111/pan.12199</identifier><identifier>PMID: 23683085</identifier><language>eng</language><publisher>France: Blackwell Publishing Ltd</publisher><subject>Anesthesia ; Anesthesia Recovery Period ; checklist ; Checklist - methods ; Child ; Continuity of Patient Care ; Hospitals ; Hospitals, Pediatric - organization &amp; administration ; Humans ; intraoperative awareness ; Intraoperative Care - methods ; Operating Rooms - organization &amp; administration ; patient handoff ; Patient Handoff - organization &amp; administration ; postoperative care ; Quality Improvement ; Recovery Room - organization &amp; administration ; Reproducibility of Results</subject><ispartof>Pediatric anesthesia, 2013-07, Vol.23 (7), p.647-654</ispartof><rights>2013 John Wiley &amp; Sons Ltd</rights><rights>2013 John Wiley &amp; Sons Ltd.</rights><rights>Copyright © 2013 John Wiley &amp; Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3919-58403b525c2f5ad340527e55b7fc95d27c4a79e78252c4d9df0906e05ab6c4e33</citedby><cites>FETCH-LOGICAL-c3919-58403b525c2f5ad340527e55b7fc95d27c4a79e78252c4d9df0906e05ab6c4e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpan.12199$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpan.12199$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23683085$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Kurth, Dean</contributor><contributor>Kurth, Dean</contributor><creatorcontrib>Boat, Anne C.</creatorcontrib><creatorcontrib>Spaeth, James P.</creatorcontrib><title>Handoff checklists improve the reliability of patient handoffs in the operating room and postanesthesia care unit</title><title>Pediatric anesthesia</title><addtitle>Paediatr Anaesth</addtitle><description>Summary Background Ineffective communications among healthcare providers are common and increases the risk of medical errors. During the perioperative period, multiple handoffs occur within a short period of time, and failure to convey important patient information can compromise safety. We used quality improvement methodology to improve the reliability of our handoffs in the operating room and postanesthesia care unit (PACU). Methods Two quality improvement teams were developed to focus on the intraoperative and postanesthesia handoff processes. Key driver diagrams and ‘smart aims’ were developed for each process based on feedback from anesthesia and nursing staff, and handoff checklists were developed and revised using multiple plan‐do‐study‐act cycles. Data on the reliability of the handoff processes were obtained prior to initiation of the projects and throughout the 6‐month project period. Results The reliability of intraoperative anesthesia handoffs improved from 20% to 100% with use of the intraoperative handoff checklist. Similarly, with the introduction of a standardized PACU checklist, the reliability of PACU handoffs improved from 59% to greater than 90%. Conclusion We utilized quality improvement methodology to develop and implement standardized checklists for handoffs of care in the operating room and PACU. Acceptance of and adherence to the standardized handoff protocols dramatically increased the quality and reliability of our handoff process.</description><subject>Anesthesia</subject><subject>Anesthesia Recovery Period</subject><subject>checklist</subject><subject>Checklist - methods</subject><subject>Child</subject><subject>Continuity of Patient Care</subject><subject>Hospitals</subject><subject>Hospitals, Pediatric - organization &amp; administration</subject><subject>Humans</subject><subject>intraoperative awareness</subject><subject>Intraoperative Care - methods</subject><subject>Operating Rooms - organization &amp; administration</subject><subject>patient handoff</subject><subject>Patient Handoff - organization &amp; administration</subject><subject>postoperative care</subject><subject>Quality Improvement</subject><subject>Recovery Room - organization &amp; administration</subject><subject>Reproducibility of Results</subject><issn>1155-5645</issn><issn>1460-9592</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAUhS0EoqV0wQsgS2xgkdY_uXa8rCqYIo2mU4mqS8txHMZtEqd2Aszb4zZtF0h4Y0vnu0fn-iD0gZITms_paIYTyqhSr9AhLQUpFCj2Or8pQAGihAP0LqVbQihngr1FB4yLipMKDtH9hRma0LbY7py963yaEvb9GMMvh6edw9F13tS-89MehxaPZvJumPBumcrs8IiF0cUsDT9xDKHHWcVjSJMZXMpy8gZbEx2eBz-9R29a0yV3_HQfoetvX3-cXxTry9X387N1YbmiqoCqJLwGBpa1YBpeEmDSAdSytQoaJm1ppHKyYsBs2aimJYoIR8DUwpaO8yP0efHNy9zPOYfufbKu63KoMCdNuQBVVVSwjH76B70NcxxyugeqlFKALDP1ZaFsDClF1-ox-t7EvaZEP_Sgcw_6sYfMfnxynOveNS_k88dn4HQBfvvO7f_vpLdnm2fLYpnIHbk_LxMm3mkhuQR9s1npq-0N325Wa13xv1FWoYE</recordid><startdate>201307</startdate><enddate>201307</enddate><creator>Boat, Anne C.</creator><creator>Spaeth, James P.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201307</creationdate><title>Handoff checklists improve the reliability of patient handoffs in the operating room and postanesthesia care unit</title><author>Boat, Anne C. ; Spaeth, James P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3919-58403b525c2f5ad340527e55b7fc95d27c4a79e78252c4d9df0906e05ab6c4e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Anesthesia</topic><topic>Anesthesia Recovery Period</topic><topic>checklist</topic><topic>Checklist - methods</topic><topic>Child</topic><topic>Continuity of Patient Care</topic><topic>Hospitals</topic><topic>Hospitals, Pediatric - organization &amp; administration</topic><topic>Humans</topic><topic>intraoperative awareness</topic><topic>Intraoperative Care - methods</topic><topic>Operating Rooms - organization &amp; administration</topic><topic>patient handoff</topic><topic>Patient Handoff - organization &amp; administration</topic><topic>postoperative care</topic><topic>Quality Improvement</topic><topic>Recovery Room - organization &amp; administration</topic><topic>Reproducibility of Results</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boat, Anne C.</creatorcontrib><creatorcontrib>Spaeth, James P.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boat, Anne C.</au><au>Spaeth, James P.</au><au>Kurth, Dean</au><au>Kurth, Dean</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Handoff checklists improve the reliability of patient handoffs in the operating room and postanesthesia care unit</atitle><jtitle>Pediatric anesthesia</jtitle><addtitle>Paediatr Anaesth</addtitle><date>2013-07</date><risdate>2013</risdate><volume>23</volume><issue>7</issue><spage>647</spage><epage>654</epage><pages>647-654</pages><issn>1155-5645</issn><eissn>1460-9592</eissn><abstract>Summary Background Ineffective communications among healthcare providers are common and increases the risk of medical errors. During the perioperative period, multiple handoffs occur within a short period of time, and failure to convey important patient information can compromise safety. We used quality improvement methodology to improve the reliability of our handoffs in the operating room and postanesthesia care unit (PACU). Methods Two quality improvement teams were developed to focus on the intraoperative and postanesthesia handoff processes. Key driver diagrams and ‘smart aims’ were developed for each process based on feedback from anesthesia and nursing staff, and handoff checklists were developed and revised using multiple plan‐do‐study‐act cycles. Data on the reliability of the handoff processes were obtained prior to initiation of the projects and throughout the 6‐month project period. Results The reliability of intraoperative anesthesia handoffs improved from 20% to 100% with use of the intraoperative handoff checklist. Similarly, with the introduction of a standardized PACU checklist, the reliability of PACU handoffs improved from 59% to greater than 90%. Conclusion We utilized quality improvement methodology to develop and implement standardized checklists for handoffs of care in the operating room and PACU. Acceptance of and adherence to the standardized handoff protocols dramatically increased the quality and reliability of our handoff process.</abstract><cop>France</cop><pub>Blackwell Publishing Ltd</pub><pmid>23683085</pmid><doi>10.1111/pan.12199</doi><tpages>8</tpages></addata></record>
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source MEDLINE; Wiley Online Library Journals Frontfile Complete
subjects Anesthesia
Anesthesia Recovery Period
checklist
Checklist - methods
Child
Continuity of Patient Care
Hospitals
Hospitals, Pediatric - organization & administration
Humans
intraoperative awareness
Intraoperative Care - methods
Operating Rooms - organization & administration
patient handoff
Patient Handoff - organization & administration
postoperative care
Quality Improvement
Recovery Room - organization & administration
Reproducibility of Results
title Handoff checklists improve the reliability of patient handoffs in the operating room and postanesthesia care unit
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