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Improving Communication Between Surgery and Critical Care Teams: Beyond the Handover
Christian James Turner1, Barbara Haas2, Christie Lee2
1Christian James Turner is an intensivist and clinical instructor, University Hospital of Northern British Columbia and University of British Columbia, Canada. Barbara Haas is an assistant professor, Interdepartmental Division of Critical Care Medicine and Division of General Surgery, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada. Christie Lee, Michael Eric Detsky, and Laveena Munshi are assistant professors, Interdepartmental Division of Critical Care Medicine, Sinai Health System, University of Toronto. Savtaj Brar is an assistant professor, Department of Surgery, Sinai Health System, University of Toronto. christianjamesturner@gmail.com.
A new communication intervention significantly improved surgical and intensive care unit (ICU) team satisfaction with postoperative handover and daily communication. This highlights the value of structured tools for enhancing inter-team collaboration and patient care.
Area of Science:
- Medical Communication
- Intensive Care Medicine
- Surgical Patient Management
Background:
- Structured communication tools for postoperative surgical handover to the intensive care unit (ICU) show promise.
- Limited research exists on ongoing daily communication between surgery and ICU teams post-handover.
Purpose of the Study:
- To evaluate a novel, two-part communication intervention for surgery and ICU teams.
- The intervention focused on improving both postoperative handover and ongoing daily communication.
Main Methods:
- A mixed-methods, pre- and postintervention survey study in a quaternary medical-surgical ICU.
- Participants (N=112) included ICU physicians, nurses, allied health professionals, and surgical physicians.
- Intervention: Postoperative handover checklist and a daily 5-item surgical team communication tool.
Main Results:
- Significant improvements in satisfaction with postoperative handover communication (P < .001) and daily communication (P = .001).
- Enhanced understanding of postoperative plans (P < .001), DVT prophylaxis initiation (P = .008), and feeding initiation (P = .009).
- No significant improvement noted in communication regarding disposition or patient safety risk from errors.
Conclusions:
- A simple handover checklist enhances healthcare practitioner satisfaction with postoperative ICU handover communication.
- Concise daily communication tools effectively improve ongoing communication between surgical and ICU teams.
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