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Improving postoperative handover from anaesthetists to non-anaesthetists in a children's intensive care unit: the
Teddy Suratos Fabila1, Hwan Ing Hee1, Rehena Sultana2
1Department of Paediatric Anaesthesia, KK Women's and Children's Hospital, Singapore.
Insights
Improving paediatric patient handover to the children's intensive care unit (CICU) requires customising both the PETS (pre-handover, equipment handover, timeout and sign out) protocol and the situation, background, assessment, and recommendation (SBAR) form.
Area of Science:
- Medical Informatics
- Patient Safety
- Healthcare Management
Background:
- Postoperative handover efficiency for paediatric patients in the children's intensive care unit (CICU) is inconsistent across institutions.
- Reorganizing handover workflows based on observational studies can enhance information transfer.
- This study evaluated a new handover process focusing on recipient perceptions of communication completeness and SBAR form usability.
Purpose of the Study:
- To assess the effectiveness of a newly developed handover process for paediatric patients transitioning to the CICU.
- To evaluate recipient perceptions regarding the completeness and clarity of verbal communication during handover.
- To determine the usability and impact of a revised situation, background, assessment, and recommendation (SBAR) form.
Main Methods:
- A prospective interventional study was conducted in a pediatric intensive care unit.
- The study involved four phases: evaluating the existing process, developing a new process based on feedback, implementation, and post-implementation evaluation.
- The new process incorporated a PETS (pre-handover, equipment handover, timeout and sign out) protocol, a single traffic communication flow, and an enhanced SBAR form with 'not applicable' and 'none' options.
Main Results:
- Significantly more recipients identified the new SBAR form as the most crucial handover tool, providing more valuable information.
- Recipient perceptions indicated improvements in information sufficiency and clarity.
- The new process led to a reduction in omission errors and fewer inconsistencies in patient descriptions.
Conclusions:
- A dual customization approach, involving both the PETS protocol and the SBAR form, is essential for optimizing handover processes.
- This tailored approach addresses the specific workflow and information requirements of the receiving clinical team.
- Effective handover is critical for ensuring patient safety and efficient care transitions in the CICU.
Introduction:
The efficiency of postoperative handover of paediatric patients to the children's intensive care unit (CICU) varies according to institutions, clinical setup and workflow. Reorganisation of handover flow based on findings from observational studies has been shown to improve the efficiency of information transfer. This study aimed to evaluate a new handover process based on recipients' perceptions, focusing on completeness and comprehensiveness of verbal communication, and the usability of a situation, background, assessment and recommendation (SBAR) form.
Methods:
This was a prospective interventional study conducted in the CICU of KK Women's and Children's Hospital, Singapore. It comprised four phases: (1) evaluation of the current handover process through an audit and opinion survey; (2) development of a new handover process based on the opinion survey and hospital personnel feedback; (3) implementation; and (4) evaluation of the new handover process. The new handover process was based on a PETS (pre-handover, equipment handover, timeout and sign out) protocol with a 'single traffic communication' flow and a new SBAR handover document. It included relevant patient information, and the options 'not applicable' and 'none', to increase compliance and reduce ambiguity.
Results:
Significantly more recipients indicated that the new SBAR form was the most important handover tool and provided more useful information. Recipients' perceptions indicated improvement in information sufficiency and clarity; reduction of omission errors; and fewer inconsistencies in patient descriptions in the new process.
Conclusion:
Dual customisation of the handover process, PETS protocol and SBAR form is necessary to meet the workflow and information demands of the receiving team.
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