Implementing the PATIENT Mnemonic During Intraoperative Hand-Offs Between CRNAs: A Quality Improvement Project

Abstract

Patient hand-offs, the exchange of information during the transfer of patient care, are essential in anesthesia practice, particularly during the intraoperative period when provider changes occur due to breaks or shift changes. In 2017, the Joint Commission identified ineffective communication as a persistent issue among healthcare providers, which increases the risk of adverse outcomes and sentinel events. For Certified Registered Nurse Anesthetists (CRNAs), the ability to communicate effectively during intraoperative patient hand-off is often hindered by interruptions and time constraints, underscoring the urgent need for improved hand-off protocols to enhance patient safety and continuity of care. This quality improvement project completed a single Plan, Do, Study, Act cycle to assess anesthesia providers' perceptions of adequacy of the PATIENT Mnemonic to facilitate standardized hand-offs of anesthetized patients. Implementation of the project took place at a level 1 trauma center and teaching hospital in the southeastern United States. Data was collected from eight CRNA volunteer participants using pre- and post-implementation surveys created and accessed via QualtricsTM. Following implementation, eighty-six percent (6/7) of responding participants reported they have received hand-off reports that could have been more comprehensive, and all (7/7) reported that implementing a standardized hand-off tool could improve completeness of anesthesia provider reports.