Intraoperative patient information handover between anesthesia providers

Dominik Choromanski, Joel Frederick, George Michael McKelvey, Hong Wang, Dominik Choromanski, Joel Frederick, George Michael McKelvey, Hong Wang

Abstract

Currently, no reported studies have evaluated intraoperative handover among anesthesia providers. Studies on anesthetic handover in the US recovery room setting observed that handover processes are insufficient and, in many instances, significant intraoperative events are disregarded. An online survey tool was sent to anesthesia providers at US anesthesia residency programs nationwide (120 out of the 132 US programs encompassing around 4500 residents and their academic MDAs) and a smaller survey selection of CRNAs (10 institutions about 300 CRNAs in the metropolitan area of Detroit, MI, USA) to collect information on handover practices. The response rate to this survey (n = 216) was comprised of approximately 5% (n = 71) of the resident population in US anesthesia programs, 5% (n = 87) of MDAs , and 20% (n = 58) of the CRNAs. Out of all respondents (n = 212), 49.1 % had no hand-over protocol at their institution and 88% of respondents who did have institutional handover protocols believed them insufficient for effective patient handover. In addiiton, 84.8% of all responders reported situations where there was insufficient information received during a patient handover. Only 7% of the respondents reported never experiencing complications or mismanagement due to poor or incomplete hand-overs. In contrast, 60% reported rarely having complications, 31% reported sometimes having complications, and 3% reported frequent complications. In conclusion, handover transition of patient care is a vulnerable and potentially life-threatening event in the operating room. Our preliminary study suggests that current intraoperatvive handover practices among anesthesia providers are suboptimal and that national patient handover guidelines are required to improve patient safety.

Keywords: anesthesiology; health care surveys; patient handover; patient safety; postoperative care.

Conflict of interest statement

The authors reported no conflict of interests.

Figures

Fig. 1. Survey question 4.
Fig. 1. Survey question 4.
On a scale from 1–5, how frequently do you cover the following patient information during the hand-over? Key - (1  =  Never, 2  =  Rarely, 3  =  Sometimes, 4  =  Frequently, 5  =  Always. Patient information factors expressed as a % proportion of total survey response.

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