Improving postoperative handoff in a surgical intensive care unit

Abstract

Background Evidence-based research demonstrates that postoperative formalized handoff improves communication and satisfaction among hospital staff members, leading to improved patient outcomes. Objective To improve postoperative patient safety in the surgical intensive care unit of a tertiary academic medical center. Methods A verbal and written formal reporting method was designed, implemented, and evaluated. The intervention created an admission “time-out,” allowing the handoff from surgical and anesthesia teams to the intensive care unit team and bedside nurses to occur in a more structured manner. Before and 1 year after implementation of the intervention, nurses completed surveys on the quality of postoperative handoff. Results After the intervention, the proportion of nurses who reported receiving handoff from the surgical team increased from 20% to 60% (P < .001). More nurses felt satisfied with the surgical handoff (46% before vs 74% after the intervention; P < .001), and more nurses frequently felt included in the handoff process (42% vs 74%; P < .001). Nurses perceived improved communication with surgical teams (93%), anesthesia teams (89%), and the intensive care unit team (94%), resulting in a perception of better patient care (88%). Conclusion After implementation of a systematic multidisciplinary handoff process, surgical intensive care nurses reported improved frequency and completeness of the postoperative handoff process, resulting in a perception of better patient care.