Improving Postoperative Handoff in a Surgical Intensive Care Unit

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Surgical Intensive Care

Background:

• Formalized handoffs are evidence-based for improving staff communication and patient outcomes.
• Postoperative patient safety in surgical intensive care units (SICUs) requires effective communication.
• Existing handoff procedures may lack structure, impacting information transfer.

Purpose of the Study:

• To enhance postoperative patient safety within a tertiary academic medical center's SICU.
• To implement and evaluate a structured, multidisciplinary handoff protocol.
• To assess the impact of the intervention on nursing staff perceptions of handoff quality.

Main Methods:

• A formal verbal and written reporting method, including an admission "time-out," was developed.
• The intervention structured the handoff from surgical/anesthesia teams to SICU teams and nurses.
• Nurse surveys were administered before and one year after intervention implementation.

Main Results:

• Nurses receiving surgical handoffs increased from 20% to 60% (P < .001).
• Satisfaction with surgical handoffs rose from 46% to 74% (P < .001), with increased inclusion (42% to 74%; P < .001).
• Perceived communication improvements with surgical (93%), anesthesia (89%), and SICU teams (94%) led to better patient care perception (88%).

Conclusions:

• A systematic, multidisciplinary handoff process improved frequency and completeness.
• Surgical intensive care nurses reported enhanced handoff processes.
• The intervention resulted in a perception of improved patient care quality.