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Abstract

Introduction: Every time a patient changes their level of care, the health care team must handoff essential information. Failure to adequately complete this process can lead to patient harm. While current research has focused on resident handoffs the critical care team is multi-professional (MP). There is less research on the multi-professional handoff. We developed a MP committee to assess our current hand off system for patients admitted directly from the OR to the SICU. Hypothesis: The goal of this study was to determine if a MP handoff would improve staff perception of handoff quality and Pt care. Methods: In 2012 we empowered a MP team of attendings in anesthesiology and critical care, nurse anesthetist, ICU nurses and fellows, and respiratory therapist to evaluate our current handoff process on direct admits from the OR to the ICU. A new process was developed to make the handoff MP. This includes a standardized report process and written communication checklist. A 10 item handoff survey on a 4 point Likert scale was developed. Of the 10 items, four had objective measures, three evaluated process, and 2 communications, the 10th item was an overall rating. Compliance and perceptions of the handoff process before and after establishing the MP handoff was compared. Responses before and after were tested using Mann Whitney U with significance set at 0.05. Results: There were 124 pre-survey and 93 post-survey responses. The average increase was 0.31 (range 0.01-0.51). There was an overall improvement and in 3 objective (30 & 5 min notice, resident presence on arrival), 2 process (Clear role defined & tine for questions), and 2 communication (adequate phone & in-person report given) measures (p < 0.05). Increased, improvements in pt stability and having a clear transition were NS. CRNAs and RN were more likely to report improvements then MDs or RTs. All team members thought the care was improved with a MP handoff. Conclusions: A structured MP handoff improves information exchange and process of care on direct admits from the OR to ICU. The checklist improves the ability to monitor the performance of the MP team and subjectively improved patient care. A future prospective evaluation of patient outcomes is warranted.