Journal of Heart and Cardiology
A Standardized Postoperative Handover Protocol Improves Inter- Provider Communication after Pediatric Cardiac Surgery
- 1Department of Pediatrics, Division of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, NY, USA
- 2Department of Pediatrics, Division of Critical Care Medicine, Icahn School of Medicine at Mount Sinai, NY, USA
Raj Sahulee, D.O. Gustave L. Levy Place, Department of Pediatrics, Division of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY-10029, Tel: 917-597-9250; E-mail: Raj.Sahulee@mssm.edu
Raj Sahulee, D.O., et al. A Standardized Postoperative Handover Protocol Improves Inter-Provider Communication after Pediatric Cardiac Surgery. (2016) J Heart Cardiol 2(1): 6-11.
© 2016 Raj Sahulee, D.O. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License.
KeywordsPatient handover; Handoff; Communication; Pediatric cardiac intensive care; Pediatric cardiac surgery
Objective: To determine if a standardized handover protocol from the operating room to the pediatric cardiac intensive care unit would be associated with an objective improvement in communication between care teams. In addition, if the protocol would be associated with improved subjective assessment with handoff, as well as provider satisfaction with the process.
Methods: In phase 1, an assessment of 20 patient handovers from the cardiac operating room to the pediatric cardiac intensive care unit at Kravis Children’s Hospital was obtained by direct observation. A checklist of 23 key elements of patient transfer recorded patient identification, procedure information, anesthesia details, patient status and the duration of handoff. Later a survey was created to evaluate care team provider’s assessment of the information transferred during handoff, and their satisfaction with the process. Next a multidisciplinary team developed a 4 step standardized handover protocol. In phase 2, another 20 patient handovers were observed, and the provider survey was repeated.
Measurements and Main Results: A total of 40 observations of patient handover were performed during the study. In phase 1, 69.3% of key handoff elements were transferred as compared to 81.3% in phase 2 (p = 0.003). The duration of the handoff was not significantly different between phases (7.85 min vs. 8.35 min; p = 0.69). There was a significant improvement in provider assessment of information transfer (6.58 vs. 7.58 mean modified Likert score; p = 0.003). There was a non-significant trend towards increased provider satisfaction with the handover process (6.26 vs. 6.85 mean modified Likert score; p = 0.33).
Conclusions: In this study, a standardized handoff protocol was associated with objective and subjective improvements in communication between care teams without increasing the duration of handoff.