Interprofessional Training and Communication Practices Among Clinicians in the Postoperative ICU Handoff

Abstract

Operating room (OR)-to-ICU handoffs require coordinated communication between clinicians with different professional backgrounds. However, individual studies have not simultaneously evaluated handoff training and OR-to-ICU handoff practices among interprofessional clinicians that participate in these team-based handoffs. The objective of this study was to characterize communication training, practices, and preferences of interprofessional clinicians who engage in OR-to-ICU handoffs. The researchers conducted a mixed methods cohort study using surveys (quantitative) and semistructured interviews (qualitative). Surveys aimed to quantitatively assess the quality of prior handoff training, preferences for clinical information in handoffs, and participation in various handoff activities. Interviews aimed to elicit more in-depth clinician perspectives on these topics through open-ended discussion. The frontline clinicians who were surveyed and interviewed included surgery and anesthesia residents, registered nurses, and advanced practice providers who worked in two ICUs at an urban academic medical center in the United States. In a survey with a 71.8% response rate (130/181), 45.7% (32/70) of residents, 17.4% (4/23) of certified registered nurse anesthetists (CRNAs), 83.3% (10/12) of ICU nurse practitioners (NPs), and 81.0% (17/21) of ICU RNs indicated that their clinical degree-granting education had not provided adequate preparation for OR-to-ICU handoffs. On-the-job training was deemed not adequate preparation by 35.7% (25/70) of residents, 21.7% (5/23) of CRNAs, 58.3% (7/12) of ICU NPs, and 23.8% (5/21) of ICU RNs. Through 30 semistructured interviews, clinicians from all professions expressed interest in interprofessional communication education and in understanding the perspectives and priorities of care team members in OR-to-ICU handoffs. Clinicians also highlighted the potential value of interprofessional communication training taking place early in a clinical career, during degree-granting education. Clinicians exhibit profession-based differences in OR-to-ICU handoff training, practices, and information needs. Education focused on interprofessional communication is a potential approach to facilitate improved OR-to-ICU handoff communication.