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Handover after pediatric heart surgery: a simple tool improves information exchange
Samara R Zavalkoff1, Saleem I Razack, Josée Lavoie
1Department of Pediatrics, McGill University, Division of Pediatric Critical Care Medicine, Montreal Children's Hospital, Montreal, Quebec, Canada. samara.zavalkoff@mcgill.ca
Insights
A simple handover tool significantly improved the quality of information exchange for pediatric cardiac surgery patients. This tool enhanced critical data transfer without increasing handover duration.
Area of Science:
- Pediatric Cardiac Surgery
- Intensive Care Medicine
- Healthcare Communication
Background:
- Effective patient handover is crucial for complex cases, particularly after pediatric cardiac surgery.
- Current handover processes may lack standardization, potentially impacting patient care quality.
- Improving information transfer is essential for optimizing outcomes in pediatric intensive care units (PICUs).
Purpose of the Study:
- To enhance the quality of patient handover following pediatric cardiac surgery.
- To implement and evaluate a simple, standardized handover tool for complex cases.
- To ensure comprehensive communication between surgical/anesthesia teams and the PICU.
Main Methods:
- Prospective, pre-/postinterventional study design.
- Implementation of a one-page, fill-in-the-blank handover tool.
- Involved 33 healthcare providers across anesthesia, critical care, and surgery in 31 handovers.
- Measured handover scores, duration, and postoperative high-risk events.
Main Results:
- Significant improvement in total handover scores (28.2 to 33.5 out of 43, p = .002).
- Enhanced medical and surgical intraoperative information subscores (p = .024 and p = .002, respectively).
- Handover duration did not significantly increase (8.3 to 11.1 minutes, p = .1).
Conclusions:
- A simple handover tool effectively improves the completeness of critical information exchange for pediatric cardiac surgery patients.
- The tool facilitates better communication without prolonging handover time.
- This approach offers a practical solution for enhancing patient safety in PICUs.
Objective:
To improve the quality of handover of complex patients after pediatric cardiac surgery through the use of a simple handover tool.
Design:
Prospective, pre-/postinterventional.
Setting:
A tertiary care, pediatric intensive care unit in North America.
Subjects:
Thirty-three consenting healthcare providers from pediatric cardiac anesthesia, critical care, and cardiothoracic surgery participating in 31 handovers.
Intervention:
A fill-in-the-blank, one-page tool was developed to guide the information transmitted by the surgeon and anesthesiologist to the pediatric intensive care unit team during handover of postcardiac surgery patients.
Measurements And Main Results:
Total handover score, four subscores, handover duration, and postoperative high-risk events were measured before and after introducing the tool into clinical practice. The patients in both the pre- and postintervention groups were similar at baseline. The total handover score (maximum 43 points) improved significantly after the implementation of the handover tool (28.2 of 43 ± 4.6 points vs. 33.5 of 43 ± 3.7 points, p = .002). There was also a significant improvement in the medical (8.3 ± 2.6 vs. 10.3 ± 2.1 points, p = .024) and surgical (7.5 ± 1.4 vs. 9.3 ± 1.6 points, p = .002) intraoperative information subscores. Use of the tool did not prolong handover duration (8.3 ± 4.6 vs. 11.1 ± 3.9 mins, p = .1). There was a trend toward more patients being free from high-risk events in the postintervention group (31.2% vs. 6.7%), but this did not reach statistical significance (p = .1).
Conclusions:
Use of a simple tool during handover of pediatric postcardiac surgery patients resulted in a more complete exchange of critical information with no significant prolongation of the handover duration.
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