Team performance during postsurgical patient handovers in paediatric care

Area of Science:

• Medical Safety
• Healthcare Teamwork
• Paediatric Critical Care

Background:

• Efficient teamwork during transfers of critically ill children is crucial for quality and safety.
• Postoperative handovers involve ad hoc teams and are prone to suboptimal performance and communication.
• Previous studies often relied on single-source assessments of team performance.

Purpose of the Study:

• To determine agreement levels on team performance during paediatric postsurgical handovers.
• To explore associations between team performance and mental demands, disruptions, and stress.
• To compare provider- and observer-rated team performance in operating room to intensive care unit transfers.

Main Methods:

• An observational, multisource study involving provider and expert-observer ratings.
• Standardized observations of 31 postsurgical patient handovers to the Paediatric Intensive Care Unit (PICU).
• Application of established teamwork tools and statistical analysis using mixed models.

Main Results:

• Low inter-provider agreement on overall handover team performance was observed.
• High levels of distractions during handover were associated with inferior team performance (B = -0.72).
• Provider-perceived team performance was rated high, but situation awareness was lower in the receiving sub-team.

Conclusions:

• Substantial disagreements exist between professionals and observers in rating teamwork during patient transfers.
• Future studies should carefully consider concurrent provider and observer assessments for evaluating paediatric teamwork.
• Handovers should be conducted with minimal distractions to ensure optimal team performance.