Anesthesia Hand-off Tool during the Preoperative Phase

Abstract

Problem: In the preoperative unit of the project site many interdisciplinary teams are required to see the patient prior to proceeding to surgery. Handoff of care from the preoperative unit to the operating room team was not a routine process leading to medication errors and decreased patient satisfaction. Purpose: The purpose of the project was to implement a standardized SBAR handoff tool, streamline the patient perioperative process, and standardize handoff of care. The outcome goal is to decrease the amount of pertinent patient information missed by utilizing the standardized handoff tool. Methods: The standardized SBAR handoff tool and process was presented using PowerPoint at the project site by the project lead during anesthesia grand rounds. Additionally, the PowerPoint presentation was distributed via email to the anesthesia department, preoperative leadership, and preoperative staff. The standardized handoff tool was completed by the preoperative nurse and utilized to facilitate face-to-face handoff. The handoff tools were collected daily by the preoperative management and collected weekly by the project lead. The handoff tools were audited by the project lead for compliance and completion. For the purposes of this project, the handoff tool was used exclusively in the surgical orthopedic patient population. Preliminary Results: After significant barriers were identified and mitigated in phase one of implementation, phase two data showed significant improvement in completing inperson transfer of care utilizing the handoff tool, with 94% compliance in the second phase versus 0% compliance in the first phase. Preliminary Conclusions: Preliminary findings suggest that the purpose of this quality improvement project was to standardize handoff of care. The goals of the project have been met by creating and implementing the handoff tool. Utilizing the handoff tool has decreased the amount of missed pertinent patient information and has improved the continuity of care for surgical patients.