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Standardized ICU to OR handoff increases communication without delaying surgery

Thomas J. Caruso (Department of Anesthesiology, Perioperative, and Pain Medicine, Lucile Packard Children’s Hospital, Stanford, California, USA)
Juan Luis Sandin Marquez (University of Michigan, Ann Arbor, Michigan, USA)
Melanie S. Gipp (Department of Anesthesiology, Perioperative, and Pain Medicine, Lucile Packard Children’s Hospital, Stanford, California, USA)
Stephen P. Kelleher (Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA)
Paul J. Sharek (Department of Pediatrics, Lucile Packard Children’s Hospital, Stanford, California, USA)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 8 May 2017

Abstract

Purpose

No studies have examined preoperative handoffs from the intensive care unit (ICU) to OR. Given the risk of patient harm, the authors developed a standardized ICU to OR handoff using a previously published handoff model. The purpose of this paper is to determine whether a standardized ICU to OR handoff process would increase the number of team handoffs and improve patient transport readiness.

Design/methodology/approach

The intervention consisted of designing a multidisciplinary, face-to-face handoff between sending ICU providers and receiving anesthesiologist and OR nurse, verbally presented in the I-PASS format. Anticipatory calls from the OR nurse to the ICU nurse were made to prepare the patient for transport. Data collected included frequency of handoff, patient transport readiness, turnover time between OR cases, and anesthesia provider satisfaction.

Findings

In total, 57 audits were completed. The frequency of handoffs increased from 25 to 86 percent (p<0.0001) and the frequency of patient readiness increased from 61 to 97 percent (p=0.001). There were no changes in timeliness of first start cases and no significant change in turnover times between cases. Anesthesia provider satisfaction scores increased significantly.

Practical implications

A standardized, team based ICU to OR handoff increased the frequency of face-to-face handoffs, patient readiness and anesthesia provider satisfaction within increasing turnover between cases.

Originality/value

Although studies have identified the transition of patients from the ICU to the OR as a period of increased harm, the development of a preoperative ICU to OR handoff had not been described. This intervention may be used in other institutions to design ICU to OR transitions of care.

Keywords

Citation

Caruso, T.J., Marquez, J.L.S., Gipp, M.S., Kelleher, S.P. and Sharek, P.J. (2017), "Standardized ICU to OR handoff increases communication without delaying surgery", International Journal of Health Care Quality Assurance, Vol. 30 No. 4, pp. 304-311. https://doi.org/10.1108/IJHCQA-02-2016-0015

Publisher

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Emerald Publishing Limited

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