Intraoperative Transitions of Anesthesia Care and Postoperative Adverse Outcomes

Saager, Leif; Hesler, Brian D.; You, Jing; Turan, Alparslan; Mascha, Edward J.; Sessler, Daniel I.; Kurz, Andrea

doi:10.1097/aln.0000000000000401

Cited by 124 publications

(117 citation statements)

References 38 publications

Supporting

Mentioning

107

Contrasting

Unclassified

Order By: Relevance

“…Hudson et al 1 found a 43% increase of in-hospital mortality and a 27% increase of major morbidity associated with intraoperative handovers between anaesthetists in cardiac surgery. Similar effects were observed by Saager et al 2 in general surgery and by Hyder et al 3 during colorectal surgery.…”

Section: Introductionsupporting

confidence: 85%

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

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionsupporting

confidence: 85%

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

View full text Add to dashboard Cite

show abstract

“…This was related to the transfer of information between different intra-operative teams prior to the postoperative handover resulting in limited time available to gain knowledge of the patient during surgery. Research on intra-operative handovers describes timing as a risk factor for handovers close to emergence and induction of anaesthesia (Testa & Emery, 2014) as well as linking the number of intra-operative handovers to increased mortality (Saager et al, 2014). Avoiding postoperative handovers with closeness in time to intra-operative handovers is difficult to eliminate, due to the way perioperative care is organised.…”

Section: Preparation and Timing Affects Handover Qualitymentioning

confidence: 99%

Postoperative patient handovers—Variability in perceptions of quality: A qualitative focus group study

Reine

Rustøen

Ræder

et al. 2018

Journal of Clinical Nursing

View full text Add to dashboard Cite

Health care providers need to be aware that postoperative handovers are affected by a set of factors related to internal (patient conditions, individual characteristics of clinicians involved and team composition) and external (timing and concurrency conflicts, handover structure) characteristics. These issues need to be acknowledged when procedures and routines for handover quality are designed, implemented and used.

show abstract

“…Fourth, care is more commonly fragmented with many hand-offs and multiple transitions of care throughout the perioperative period [14]. No single provider 'owns' the entire course of care.…”

Section: What Is Wrong With the Current Model(s) Of Care?mentioning

confidence: 99%

“…Similarly, we should build on the experience -both positive and negative with the use of telemedicine in the ICU and emergency department setting as well as other remote monitoring capabilities to identify lessons learned and their application in perioperative management. Finally, we need to identify the ways to improve communication and coordination of all aspects of care [14].…”

Section: Redefining Roles Of Physician and Nonphysician Providers In mentioning

confidence: 99%

The future of anesthesiology

Prielipp

Cohen

2016

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

show abstract

Intraoperative Transitions of Anesthesia Care and Postoperative Adverse Outcomes

Abstract: Intraoperative anesthesia care transitions are strongly associated with worse outcomes, with a similar effect size for attendings, residents, and nurse anesthetists.

Cited by 124 publications

References 38 publications

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

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

Postoperative patient handovers—Variability in perceptions of quality: A qualitative focus group study

The future of anesthesiology

Contact Info

Product

Resources

About