Optimizing postoperative handover to the intensive care unit at a tertiary centre

Area of Science:

• Quality Improvement
• Patient Safety
• Healthcare Management

Background:

• Effective patient handover from operating theatre to intensive care unit (ICU) is critical for care quality and safety.
• The unique challenges of this handover setting necessitate targeted improvement strategies.
• A quality improvement project focused on enhancing information transfer for postoperative patients to the ICU.

Purpose of the Study:

• To assess and improve the quality of information transfer during postoperative patient handovers to the ICU.
• To identify specific areas needing improvement in the handover process.
• To evaluate the impact of interventions on handover quality.

Main Methods:

• A quality improvement project utilized the plan-do-study-act (PDSA) methodology over three months.
• Baseline audit assessed intraoperative and postoperative details for 30 patients.
• Two intervention cycles, centered on a novel checklist and stakeholder engagement, were implemented and audited.

Main Results:

• Baseline audit revealed significant areas for improvement in all handover domains.
• Introduction of a novel checklist (PDSA cycle 1) improved performance across most domains (>70%).
• Stakeholder engagement (PDSA cycle 2) showed overall improvement but a decrease in performance in some domains compared to cycle 1.

Conclusions:

• Simple interventions, including a novel checklist, effectively improved postoperative patient handover to the ICU.
• Sustained improvement hinges on global staff engagement and integrating changes into routine clinical practice.
• Ongoing monitoring and adaptation are essential for long-term success in handover quality.