Operating Room-to-ICU Patient Handovers: A Multidisciplinary Human-Centered Design Approach.

Area of Science:

• Healthcare improvement science
• Human-centered design
• Patient safety

Background:

• Surgical patient handovers from the operating room (OR) to the intensive care unit (ICU) are prone to issues like poor teamwork, unclear procedures, and distractions.
• A human-centered design (HCD) approach was applied to redesign the OR-to-ICU handover process for a broad surgical ICU (SICU) population.

Purpose of the Study:

• To redesign and evaluate the OR-to-ICU patient handover process using a human-centered approach.
• To improve communication and processes during critical patient transfers.
• To enhance the experiences of healthcare providers involved in patient handovers.

Main Methods:

• Ethnographic methods, including observations, surveys, interviews, and focus groups, were used to study existing handover practices at the Durham VA Medical Center SICU.
• The handover process was redesigned based on participant input and medical literature to address identified workflow, information needs, and expectations.
• A pre- and post-intervention study design was employed to evaluate the impact of the redesigned handover process.

Main Results:

• While information transfer scores and interruption frequency remained unchanged, significant improvements were observed in staff workload and team behavior scores.
• The redesigned handover process did not prolong the duration of patient transfers.
• Handover participants reported significantly higher satisfaction with the new handover method compared to the previous process.

Conclusions:

• A human-centered design approach effectively improved the OR-to-ICU patient handover process in a mixed adult surgical ICU population.
• The foundational principles of HCD are broadly applicable for redesigning clinical processes, even if specific implementations require adaptation to different settings.
• The study highlights the value of involving end-users in process redesign to enhance healthcare delivery and staff experience.