Conformity Through Communication: A Quality Improvement Project Implementing a Standardized Handoff Checklist from Anesthesia to the Post-Anesthesia Care Unit

Abstract

Background: The transfer of care from anesthesia providers to PACU nurses has been recognized as a high-risk handoff vulnerable to information degradation.

Objectives: Introduction of a Targeted Solutions Tool (TST) a checklist used by anesthesia providers when patients transition from the operating room to the PACU to decrease callbacks for clarification by the PACU nurse.

Methods: The Robins & Dai (2015) TST handoff checklist was implemented at a rural Southeastern North Carolina hospital for three months. Frequency of callbacks before and after implementation of the checklist was compared.

Results: Study outcomes resulted in a 19.3% pre-intervention callback rate compared to 5.6% post-intervention (p < .0005). The ability to recall all key elements of report during handoff was (99%) when using the checklist, and (73%) without the checklist (p < .0005). The results demonstrated improved handoff satisfaction by the PACU nurse an adequacy rating of 97.3% (p < .0005). Overall, there was an increase in the report handoff time (p < .0005).

Conclusions: The utilization of a TST report handoff checklist in the high-risk environment such as anesthesia to PACU has shown to reduce callbacks to anesthesia, supporting TJC’s (2012) recommendations for utilizing a TST for improved handoff communication.