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Patient Handoff

Researchers Seek to Standardize Patient Handoff Protocols

By Jonathan Springston, Editor, Relias Media

Investigators at a Philadelphia medical facility implemented standardized protocols to ensure a smooth and safe transition for patients moving from an operating room (OR) after surgery to the recovery ICU.

Handoffs occur when healthcare providers transition a patient from one part of the care continuum to the next (e.g., moving a patient after surgery from the OR to the recovery ICU). Ensuring smooth transitions is critical to patient safety. However, communication failures and other barriers can derail the process.

At the Perelman School of Medicine at the University of Pennsylvania, researchers used a fuzzy-set qualitative comparative analysis to characterize combinations of conditions derived from post-intervention handoff observations (OR to ICU), which yielded qualitative and quantitative data. Investigators were seeking the right conditions through which there would be “high fidelity,” or close adherence, to standardized protocols.

The authors identified three sets of conditions that led to high fidelity to handoff protocols: presence of the ICU provider and high attention ratings; newly admitted patient, presence of the ICU provider, and quiet environment; and newly admitted patient, high attention ratings, and quiet environment. Of 60 handoffs studied, researchers found these scenarios explained 93.5% of the cases demonstrating high fidelity.

In an editorial accompanying the study, those authors wrote, “Large-scale adoption and reach of evidence-based handoff strategies should consider the core principles of implementation science. Using mixed methods (qualitative, quantitative) measurement systems will be essential to detect and understand the influence of handoff barriers and enablers on implementation strategies and outcomes.”

For more on this and related subjects, be sure to read the latest issues of Healthcare Risk Management.