Intraoperative Anesthesia Handoff Communication Tool to Reduce Omission Errors

Abstract

The intraoperative patient handoff between anesthesia providers is often given less focus compared to post-operative handoff communication. There are many recommendations to establish a structured and standardized intraoperative handoff communication process using a cognitive tool such as a checklist. However, current practice in many clinical settings is solely relied on traditional verbal communication based on the provider’s memory. The purpose of this project was to introduce the PATIENT checklist as an intraoperative handoff tool for anesthesia providers at a 178-bed hospital in Phoenix and encourage the adoption of the handoff tool that incorporates the needs of the anesthesia department. The project design includes a convenience sample of 27 anesthesia providers at a hospital in the Phoenix metropolitan area. A total of 22 providers participated in all phases of the project. Prior to this project, there was no standardized process for intraoperative handoff at this facility and 77% (n=17) of the providers solely rely on a verbal report from memory for the handoff. The methodology for this project is a descriptive design guided by the Advancing Research and Clinical practice through close Collaboration (ARCC) model and included pre-intervention education and a post-intervention survey. The results revealed that 95% of the providers (n=21) are in favor of using the PATIENT checklist in their future practice for intraoperative handoff. The use of the checklist for handoff improved to 59% (n=13) about half the time or more. Checklist improved the verbal handoff communication with 77% (n=17) providers and 76% (n=16) revealed a standardized handoff process tool is an effective way of transferring information about half the time or more. A clinical setting specific checklist can improve the acceptance and appropriateness of handoff communication.