Addressing the Mandate for Hand-off Education

Lane‐Fall, Meghan; Brooks, Amber; Wilkins, Sara A.; Davis, Joshua; Riesenberg, Lee Ann

doi:10.1097/aln.0000000000000070

Cited by 36 publications

(10 citation statements)

References 92 publications

(96 reference statements)

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“…Communications errors are estimated to account for 70% of preventable medical errors; half of which occur during patient handovers. 22, 23 Significant strides have been made to address this problem, most notably in post-operative handovers, where standardization and customization (i.e., to the unit and needs of the specific patient population) has resulted in increased provider satisfaction, improved teamwork and work efficiency, higher quality clinical communications, error reduction, and better patient outcomes. 4, 24 Preoperative handovers have been much less studied and published intervention studies with patient-specific outcomes are nearly non-existent.…”

Section: Discussionmentioning

confidence: 99%

Impact of patient handover structure on neonatal perioperative safety

et al. 2019

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Objective To compare the incidence, severity, preventability, and contributing factors of non-routine events - deviations from optimal care based on the clinical situation - associated with team-based, nurse-to-nurse, and mixed handovers in a large cohort of surgical neonates. Study Design A prospective observational study and one-time cross-sectional provider survey were conducted at one urban academic children’s hospital. 130 non-cardiac surgical cases in 109 neonates who received pre- and post-operative NICU care. Results The incidence of clinician-reported NREs was high (101/130 cases, 78%) but did not differ significantly across acuity-tailored neonatal handover practices. National Surgical Quality Improvement – Pediatric occurrences of major morbidity were significantly higher (p<0.001) in direct team handovers than indirect nursing or mixed handovers. Conclusions NREs occur at a high rate and are of variable severity in neonatal perioperative care. NRE rates and contributory factors were homogenous across handover types. Surveyed clinicians recommend structured handovers for all patients at every transfer point regardless of acuity.

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Section: Discussionmentioning

confidence: 99%

Impact of patient handover structure on neonatal perioperative safety

et al. 2019

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“…Data have shown that these handoffs are times of significant risk to patients. 1 Specifically, studies have shown that handoffs from OR to postanesthesia care unit (PACU) and from OR to ICU often are laden with inaccuracies and miscommunication. 2,3 Three recent studies about handoffs and patient outcomes reported that there was a significant association between handovers and harm to patients.…”

Section: Introductionmentioning

confidence: 99%

Anesthesiology Handoff Simulation Case: A Handoff From Intensive Care Unit to Operating Room for Anesthesiology Learners

et al. 2020

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Introduction:Handoffs have been shown to be a potential cause of communication failures, leading to possible inefficiencies and patient harm. We noticed that our CA-1 residents were struggling with patient handoffs and designed this simulation to improve their handoff skills. Methods: This anesthesiology-specific simulation introduced learners to the perioperative handoff process. We designed it for anesthesiology learners, including junior residents, medical students, and student nurse anesthetists. The simulation centered upon an anesthesiology resident taking care of an ICU patient and handing that patient off to another anesthesiology provider, who took the patient to the OR. We charged learners with reviewing the patient's history and hospital course and giving a complete handoff. We evaluated learners on the completeness and quality of the handoff, as well as on their performance during the session. Results: Twenty-seven learners participated in this handoff simulation. The participants reported that the simulation improved their understanding of the anesthetic implications of medical conditions and gave them a better understanding of the essential elements of a handoff. Learners also indicated that the debriefing portion of the simulation was effective in filling some of their medical knowledge gaps and improving their handoff skills. Discussion: This simulation was found to be an effective educational experience for our CA-1 and CA-3 residents, medical students, and student nurse anesthetists. Feedback was positive from all learners. As a result, this simulation will be implemented in the early learning curriculum for all of our CA-1 residents.

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“…Most of these studies are difficult to interpret due to methodological bias stemming from the fact that the observations were not blinded. 8–13 In addition, the effect of handover protocols and checklists may be difficult to extrapolate to other countries, particularly when standardised communication is not yet a common part of everyday practice (currently the situation in France).…”

Section: Introductionmentioning

confidence: 99%

Training in intraoperative handover and display of a checklist improve communication during transfer of care

Jullia

Tronet

Fraumar

et al. 2017

European Journal of Anaesthesiology

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BACKGROUNDHandovers during anaesthesia are common, and failures in communication may lead to morbidity and mortality.OBJECTIVESWe hypothesised that intraoperative handover training and display of a checklist would improve communication during anaesthesia care transition in the operating room.DESIGNInterventional cohort study.SETTINGSingle-centre tertiary care university hospital.PARTICIPANTSA total of 204 random observations of handovers between anaesthesia providers (residents and nurse anaesthetists) over a 6-month period in 2016.INTERVENTIONTwo geographically different hospital sites were studied simultaneously (same observations, but no training/checklist at the control site): first a 2-week ‘baseline’ observation period; then handover training and display of checklists in each operating room (at the intervention site only) followed by an ‘immediate’ second and finally a third (3 months later) observation period.MAIN OUTCOME MEASURESA 22-item checklist was created by a modified DELPHI method and a checklist score calculated for each handover by adding the individual scores for each item as follows: −1, if error in communicating item; 0, unreported item; 0.5, if partly communicated item; 1, if correctly communicated item.RESULTSBefore training and display of the checklist, the scores in the interventional and the control groups were similar. There was no improvement in the control group's scores over the three observation periods. In the interventional group, the mean (95% confidence interval) score increased by 43% [baseline 7.6 (6.7 to 8.4) n = 42; ‘immediate’ 10.9 (9.4 to 12.4) n = 27, P < 0.001]. This improvement persisted at 3 months without an increase in the mean duration of handovers.CONCLUSIONIntraoperative handover training and display of a checklist in the operating room improved the checklist score for intraoperative transfer of care in anaesthesia.

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Addressing the Mandate for Hand-off Education

Cited by 36 publications

References 92 publications

Impact of patient handover structure on neonatal perioperative safety

Impact of patient handover structure on neonatal perioperative safety

Anesthesiology Handoff Simulation Case: A Handoff From Intensive Care Unit to Operating Room for Anesthesiology Learners

Training in intraoperative handover and display of a checklist improve communication during transfer of care

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