• Dhriti Mukhopadhyay, Katie C Wiggins-Dohlvik, Mary M MrDutt, Jeffrey S Hamaker, Graham L Machen, Matthew L Davis, Justin L Regner, Randall W Smith, David P Ciceri, and Jay G Shake.
• Texas A&M University/Scott and White Hospital, Temple, TX, USA. Electronic address: dhriti@utexas.edu.
• Am. J. Surg. 2018 Jan 1; 215 (1): 28-36.

BackgroundThe transfer of critically ill patients from the operating room (OR) to the surgical intensive care unit (SICU) involves handoffs between multiple providers. Incomplete handoffs lead to poor communication, a major contributor to sentinel events. Our aim was to determine whether handoff standardization led to improvements in caregiver involvement and communication.MethodsA prospective intervention study was designed to observe thirty one patient handoffs from OR to SICU for 49 critical parameters including caregiver presence, peri-operative details, and time required to complete key steps. Following a six month implementation period, thirty one handoffs were observed to determine improvement.ResultsA significant improvement in presence of physician providers including intensivists and surgeons was observed (p = 0.0004 and p < 0.0001, respectively). Critical details were communicated more consistently, including procedure performed (p = 0.0048), complications (p < 0.0001), difficult airways (p < 0.0001), ventilator settings (p < 0.0001) and pressor requirements (p = 0.0134). Conversely, handoff duration did not increase significantly (p = 0.22).ConclusionsImplementation of a standardized protocol for handoffs between OR and SICU significantly improved caregiver involvement and reduced information omission without affecting provider time commitment.Copyright © 2017 Elsevier Inc. All rights reserved.

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