A Multimodal Intervention Improves Postanesthesia Care Unit Handovers

Weinger, Matthew B.; Slagle, Jason; Kuntz, Audrey; Schildcrout, Jonathan S.; Banerjee, Arna; Mercaldo, Nathaniel D.; Bills, James L.; Wallston, Kenneth A.; Speroff, Theodore; Patterson, Emily S.; France, Danile J.

doi:10.1097/01.sa.0000480639.60535.78

Cited by 4 publications

(7 citation statements)

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“…In the handovers using the ISBAR‐based checklist, more information was transferred according to the PoHAT even though the checklist was not identical to the PoHAT. The effects of using checklists to increase information transfer during patient handovers in postoperative settings are well documented in the literature (Nagpal et al, 2013; Petrovic et al, 2015; Pucher et al, 2015; Segall et al, 2012; Weinger et al, 2015). However, maintaining compliance with checklists in healthcare settings is challenging (Russ et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

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Exploring postoperative handover quality in relation to patient condition: A mixed methods study

Reine

Aase

Ræder

et al. 2021

Journal of Clinical Nursing

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Aims and Objectives To describe postoperative handover reporting and tasks in relation to patient condition and situational circumstances, in order to identify facilitators for best practices. Background High‐quality handovers in postoperative settings are important for patient safety and continuity of care. There is a need to explore handover quality in relation to patient condition and other affecting factors. Design Observational mixed methods convergent design. Methods Postoperative patient handovers were observed collecting quantitative (n = 109) and qualitative data (n = 48). Quantitative data were collected using the postoperative handover assessment tool (PoHAT), and a scoring system assessing patient condition. Qualitative data were collected using free‐text field notes and an observational guide. The study adheres to the GRAMMS guideline for reporting mixed methods research. Results Information omissions in the handovers observed ranged from 1–13 (median 7). Handovers of vitally stable and comfortable patients were associated with more information omissions in the report. A total of 50 handovers (46%) were subjected to interruptions, and checklist compliance was low (13%, n = 14). Thematic analysis of the qualitative data identified three themes: “adaptation of handover,” “strategies for information transfer” and “contextual and individual factors.” Factors facilitating best practices were related to adaptation of the handover to patient condition and situational circumstances, structured verbal reporting, providing patient assessments and dialogue within the handover team. Conclusions The variations in items reported and tasks performed during the handovers observed were related to patient conditions, situational circumstances and low checklist compliance. Adaptation of the handover to patient condition and situation, structured reporting, dialogue within the team and patient assessments contributed to quality. Relevance to clinical practice It is important to acknowledge that handover quality is related to more than transfer of information. The present study has described how factors related to the patient and situation affect handover quality.

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Section: Discussionmentioning

confidence: 99%

“…In a study on the Safe Surgery Checklist, compliance was increased when the checklist was integrated in the electronic documentation system (Gitelis et al, 2017). Interventions involving team training and education have also contributed to increased checklist compliance (Bergs et al, 2015; Papadakis et al, 2019; Weinger et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Exploring postoperative handover quality in relation to patient condition: A mixed methods study

Reine

Aase

Ræder

et al. 2021

Journal of Clinical Nursing

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“…Intraoperative handovers between anaesthesia providers and during transitions of care to the PACU and ICU also have high potential for communication failure 19,20 and for adverse patient consequences. 21e25 In our study, handover communication failures only accounted for nine (10%) of the 86 claims, where a handover failure was possible.…”

Section: Handoversmentioning

confidence: 99%

“…28 Standardised handover training with complete and consistent teams using electronic tools facilitates improving the quality of the handover communication between anaesthesia teams and the PACU and ICU. 19,20,29,30…”

Section: Handoversmentioning

confidence: 99%

Communication failures contributing to patient injury in anaesthesia malpractice claims☆

Douglas

Stephens

Posner

et al. 2021

British Journal of Anaesthesia

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Background: Communication amongst team members is critical to providing safe, effective medical care. We investigated the role of communication failures in patient injury using the Anesthesia Closed Claims Project database. Methods: Claims associated with surgical/procedural and obstetric anaesthesia and postoperative pain management for adverse events from 2004 or later were included. Communication was defined as transfer of information between two or more parties. Failure was defined as communication that was incomplete, inaccurate, absent, or not timely. We classified root causes of failures as content, audience, purpose, or occasion with inter-rater reliability assessed by kappa. Claims with communication failures contributing to injury (injury-related communication failures; n¼389) were compared with claims without any communication failures (n¼521) using Fisher's exact test, t-test, or ManneWhitney U-tests.Results: At least one communication failure contributing to patient injury occurred in 43% (n¼389) out of 910 claims (k¼0.885). Patients in claims with injury-related communication failures were similar to patients in claims without failures, except that failures were more common in outpatient settings (34% vs 26%; P¼0.004). Fifty-two claims had multiple communication failures for a total of 446 injury-related failures, and 47% of failures occurred during surgery, 28% preoperatively, and 23% postoperatively. Content failures (insufficient, inaccurate, or no information transmitted) accounted for 60% of the 446 communication failures. Conclusions: Communication failure contributed to patient injury in 43% of anaesthesia malpractice claims. Patient/case characteristics in claims with communication failures were similar to those without failures, except that failures were more common in outpatient settings.

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“…Selbst wenn die oben genannten erhobenen Zahlen der WHO bezüglich me- [16,17]. Dies macht eindrücklich klar, welchen hohen Stellenwert standardisierte Über-gaben haben.…”

Section: Maßnahmen Zur Verbesserung Der Patientensicherheitunclassified

Patientenversorgung – aber sicher

Vogt

Sopka

2017

Anaesthesist

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A Multimodal Intervention Improves Postanesthesia Care Unit Handovers

Cited by 4 publications

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Exploring postoperative handover quality in relation to patient condition: A mixed methods study

Exploring postoperative handover quality in relation to patient condition: A mixed methods study

Communication failures contributing to patient injury in anaesthesia malpractice claims☆

Patientenversorgung – aber sicher

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