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For: Pallekonda V, Scholl AT, McKelvey GM, Amhaz H, Essa D, Narreddy S, Tan J, Templonuevo M, Ramirez S, Petrovic MA. A Novel Process Audit for Standardized Perioperative Handoff Protocols. Jt Comm J Qual Patient Saf 2017;43:611-618. [DOI: 10.1016/j.jcjq.2017.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/19/2017] [Accepted: 04/23/2017] [Indexed: 11/30/2022]

For:	Pallekonda V, Scholl AT, McKelvey GM, Amhaz H, Essa D, Narreddy S, Tan J, Templonuevo M, Ramirez S, Petrovic MA. A Novel Process Audit for Standardized Perioperative Handoff Protocols. Jt Comm J Qual Patient Saf 2017;43:611-618. [DOI: 10.1016/j.jcjq.2017.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/19/2017] [Accepted: 04/23/2017] [Indexed: 11/30/2022]

Number	Cited by Other Article(s)
1	An observational study of postoperative handoff standardization failures. Int J Med Inform 2021;151:104458. [PMID: 33932762 DOI: 10.1016/j.ijmedinf.2021.104458] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/20/2021] [Accepted: 04/06/2021] [Indexed: 11/20/2022] Abstract BACKGROUND Patient handoffs from an operating room (OR) to an intensive care unit (ICU) require precise coordination among surgical, anesthesia, and critical care teams. Although several standardized handoff strategies have been developed, their sustainability remains is poor. Little is known regarding factors that impede handoff standardization. PURPOSE Our objectives are three-fold: (1) highlight compliance failures with standardized handoffs; (2) identify factors contributing to compliance failures; and (3) develop guidelines for sustainable handoff interventions and processes. METHODS We used ethnographic data collection methods-general observations, handoff shadowing, and semi-structured clinician interviews-with 84 participants from OR, ICU, and telemedicine teams at a large academic medical center. We conducted thematic analysis supported by inductive and deductive coding using the Systems Engineering Initiative for Patient Safety (SEIPS) framework. RESULTS Post-operative handoffs can be characterized into four phases: pre-transfer preparation, transfer and setup, report preparation and delivery, and post-transfer care. We identified compliance failures with standardized handoff protocols and associated risk factors within the OR-ICU work system including limited teamwork, absence of handoff-specific tools, and poor clinician buy-in. To improve handoffs, clinicians provided suggestions for developing collaborative Electronic Health Record (EHR)-integrated handoff tools and re-engineering the handoff process. CONCLUSIONS Compliance failures are prevalent in all handoff phases, leading to poor adherence with standardization. We propose theoretically grounded guidelines for designing "flexibly standardized" bundled handoff interventions for ensuring care continuity in OR to ICU transitions of care. Collapse Key Words Communication Compliance Patient transfer Safety Surgical patients Collapse MESH Headings Collapse Grants Collapse Affiliation(s) Collapse

Number

Cited by Other Article(s)

An observational study of postoperative handoff standardization failures. Int J Med Inform 2021;151:104458. [PMID: 33932762 DOI: 10.1016/j.ijmedinf.2021.104458] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/20/2021] [Accepted: 04/06/2021] [Indexed: 11/20/2022]

Abstract

BACKGROUND

Patient handoffs from an operating room (OR) to an intensive care unit (ICU) require precise coordination among surgical, anesthesia, and critical care teams. Although several standardized handoff strategies have been developed, their sustainability remains is poor. Little is known regarding factors that impede handoff standardization.

PURPOSE

Our objectives are three-fold: (1) highlight compliance failures with standardized handoffs; (2) identify factors contributing to compliance failures; and (3) develop guidelines for sustainable handoff interventions and processes.

METHODS

We used ethnographic data collection methods-general observations, handoff shadowing, and semi-structured clinician interviews-with 84 participants from OR, ICU, and telemedicine teams at a large academic medical center. We conducted thematic analysis supported by inductive and deductive coding using the Systems Engineering Initiative for Patient Safety (SEIPS) framework.

RESULTS

Post-operative handoffs can be characterized into four phases: pre-transfer preparation, transfer and setup, report preparation and delivery, and post-transfer care. We identified compliance failures with standardized handoff protocols and associated risk factors within the OR-ICU work system including limited teamwork, absence of handoff-specific tools, and poor clinician buy-in. To improve handoffs, clinicians provided suggestions for developing collaborative Electronic Health Record (EHR)-integrated handoff tools and re-engineering the handoff process.

CONCLUSIONS

Compliance failures are prevalent in all handoff phases, leading to poor adherence with standardization. We propose theoretically grounded guidelines for designing "flexibly standardized" bundled handoff interventions for ensuring care continuity in OR to ICU transitions of care.

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