A quantitative study on personnel’s experiences with patient handovers between the operating room and the postoperative anesthesia care unit before and after the implementation of a structured communication tool

Abstract

Postoperative handover of patients has been described as a complex work process challenged by interruptions, time pressure and a lack of supporting framework. The purpose of this study was to investigate involved personnel’s experiences with the quality of patient handovers between the operating room and the postoperative anesthesia care unit (PACU) before and after implementation of a structured tool for communication. The study was conducted in a hospital in South-eastern Norway. Personnel completed a questionnaire before (n=116) and after (n=90) implementation of the Identification-Situation-Assessment- Recommendations (ISBAR)- tool. Analysis included summative statistics, t-tests and generalized linear regression analysis. Statistical significance assumed at P<0.05. The overall impression of quality in handovers improved significantly after implementation of the ISBAR (P=0.001). Personnel’s experiences were improved in relation to that handovers followed a logical structure, available documentation was used and all relevant information was communicated (P<0.001). Moreover, personnel found it easier to establish contact at the beginning of the handover, ambiguities were resolved and documentation was more complete (P=0.001). Profession was associated with seven of the statements, relating to whether relevant information is clearly communicated, whether possible risks and complications are discussed, contact easily established, and to completeness of documentation and information. In addition, findings indicate significantly more negative experiences among receiving personnel both pre- and post-implementation. Implementation of a structured tool for communication in patient handovers, may improve quality and safety in patient handovers between the operating room and the PACU. Research is needed to define optimal patient handovers and to determine the effect of handover quality on patient outcomes.