Evaluating safety of handoffs between anesthesia care providers

Anesthesia care providers frequently exchange care of patients among one another. This daily process of information exchange could be a potential source for adverse events.

Our objectives were to determine if the current handoff system is ineffective and if more standardized methods available for the exchange of patient information could improve the effectiveness of handoffs.

We distributed a survey to all anesthesia staff, residents, and nurse anesthetists. The survey queried the following: handoff adequacy, location for best handoff, method for best handoff, and need for inclusion in the electronic medical record.

We received 80 completed initial surveys from anesthesia staff, residents, and nurse anesthetists. Of those surveyed, 20% found the existing handoff process inadequate. Most reported both giving and receiving a poor or incomplete handoff within the previous year (84% and 57%, respectively), and 25% related an adverse outcome to a poor handoff. An overwhelming majority, 89%, felt that standardization of this process could improve patient care; 68% reported that ideal handoffs would occur in the record, as well as in person; and 62% believed that handoffs should be incorporated into the electronic medical record.

These data will be used to improve the method of the patient care handoff and have assisted us in devising techniques that can be incorporated into daily practice, advancing the safety of handoffs and decreasing complications. A handoff screen has been included on the electronic anesthesia record, encouraging a more formalized procedure for handoffs, thereby promoting patient safety.