Implementation of Standardized Handoff Report in the Post Anesthesia Care Unit

BACKGROUND: Handoff communication is a critical event as it involves the transfer of patient details, authority, and responsibility from one clinician to another. The variations in handoff can lead to increased opportunities for clinician error due to the distinct possibility of the anesthesia providers omitting critical patient information.

LOCAL PROBLEM: The site for this quality improvement project is an academic medical center in the Southeastern region. The purpose of this quality improvement project was to implement a standardized anesthesia handoff tool for anesthesia providers. The aim of this project was after one month of implementation, the mean anesthesia handoff time will decrease from 70 seconds to 55 seconds and anesthesia handoff will be 65% complete using the WHAT tool.

METHODS: The Johns Hopkins’s Evidence-Based Practice model was used as the framework for this project. Education was provided to all anesthesia providers regarding the project design and description of the tool. The outcome measures for data collection included mean handoff time and completeness of the handoff tool pre- and post-implementation.

INTERVENTIONS: The SRNA project team members observed and recorded the handoff that occurred between the anesthesia providers pre- and post-implementation. The completeness of the WHAT tool and handoff time data was compiled and analyzed.

RESULTS: The average recorded time it took to complete hand off decreased from 67.9 seconds to 48.9 seconds post implementation, which met our aim. When looking at completed tools turned in over the entire course of the project, the completeness of the tool rose from 3.8/8 (or 47.5%) to 6.4/8 (or 80%), which also surpassed our aim.

CONCLUSIONS: The results produced from the project showed that the implementation of a standardized handoff tool has positive impacts on the handoff process. When considering the improved efficiency and the low economic impact of the handoff tool, the tool can feasibly be integrated into the standard of care.