Improved Anesthesia Handoff After Implementation of the Written Handoff Anesthesia Tool (WHAT)

Patient safety may be at risk when details are omitted during anesthesia handoff. The Written Handoff Anesthesia Tool (WHAT), designed by the author, was implemented to improve the quality of anesthesia handoffs in the operating room and postanesthesia care unit (PACU). The author used the Anesthesia Handoff Communication survey to evaluate Certified Registered Nurse Anesthetist (CRNA) and PACU registered nurse (RN) satisfaction with anesthesia handoff and the Targeted Solutions Tool to identify the adequacy, contributing factors, and specific patient data omitted by senders of anesthesia handoff before and after implementation of the WHAT. Adequacy of the handoff process significantly improved for CRNAto-PACU RN (P < .0001) and CRNA-to-CRNA (P < .0001) handoffs. After implementation of the WHAT, satisfaction with anesthesia handoff significantly improved for CRNAs (P < .001) and PACU RNs (P = .001). Factors contributing to inadequate handoffs and omitted patient details were identified and significantly improved for CRNA-to-PACU RN and CRNA-to-CRNA handoffs, respectfully: ineffective method (P < .001; P < .001), baseline vital signs (P = .009; P = .014), and preoperative neurologic status (P = .012; P = .004). Implementation of the WHAT led to evidence-based changes in practice, standardization, and improved anesthesia handoff communication.