Improving quality of care in less than 1 min: a prospective intervention study on postoperative handovers to the ICU/PACU

BMJ Open Quality

article

Niklas Keller¹  Götz Bosse¹  Belinda Memmert¹  Sascha Treskatsch³  Claudia Spies¹ 

[1] Department of Anesthesiology and Operative Intensive Care Medicine, Campus Virchow Klinikum and Charité Centrum Mitte ,(CVK/CCM) , Charité Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin, Institute of Health;Simply Rational – The Decision Institute;Department of Anesthesiology and Intensive Care Medicine, Campus Benjamin Franklin ,(CBF) , Charité Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health

关键词: hand-off;    quality improvement;    critical care;    human factors;   

DOI  :  10.1136/bmjoq-2019-000668

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Purpose1 min in situ training intervention to improve the quality of postoperative handovers to the intensive care unit (ICU) and postoperative care unit.Materials and methods The VA was constructed and implemented via a brief (<1 min) training of anaesthesiologic staff during the operation. Ease of implementation was measured by amount of information transferred, handover duration and handover structure. 50 handovers were audio recorded before intervention and 50 after intervention. External validity was evaluated by blinded assessment of the recordings by experienced anaesthesiologists (n=10) on 10-point scales.Results The brief intervention resulted in increased information transfer (9.0–14.8 items, t(98)=7.44, p<0.0001, Cohen’s d=1.59) and increased handover duration (81.3–192.8 s, t(98)=6.642, p=0.013, Cohen’s d=1.33) with no loss in structure (1.60–1.56, t(98)=0.173, p=0.43). Blinded assessment on 10-point scales by experienced anaesthesiologists showed improved overall handover quality from 7.1 to 7.8 (t(98)=1.89, p=0.031, Cohen’s d=0.21) and improved completeness of information (t(98)=2.42, p=0.009, Cohen’s d=0.28) from 7.3 to 8.3.Conclusions An intervention consisting of a simple VA and <1 min instructions significantly increased overall quality and amount of information transferred during ICU/postanaesthetic care unit handovers.

【 授权许可】

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