Evaluation of Intraoperative Hand-Off Frequency, Duration, and Context: A Mixed Methods Analysis

Area of Science:

• Healthcare Operations
• Patient Safety
• Surgical Team Dynamics

Background:

• Operating room hand-offs are critical communication points.
• Poorly coordinated hand-offs can negatively impact team function and patient safety.
• Hand-offs represent a potential opportunity for enhanced communication.

Purpose of the Study:

• To investigate the coordination and impact of intraoperative hand-offs.
• To understand the frequency and timing of hand-offs in relation to surgical events.

Main Methods:

• Prospective audio-video recording of 10 operations.
• Evaluation of intraoperative hand-offs, including timing and team member presence.
• Analysis of hand-off interruptions, simultaneous occurrences, and communication strategies (announcements, anchoring).

Main Results:

• 74 hand-offs occurred, totaling 7.7% of recorded time.
• 45.1% of hand-offs were delayed or interrupted by competing activities.
• Team members were absent during 40.7% of recorded time, with >1 member absent 20.5% of the time.

Conclusions:

• Intraoperative hand-offs are frequent but often poorly coordinated with surgical events.
• Strategies like anchoring and announcements were infrequently utilized.
• Optimizing the timing, content, and participation in hand-offs is crucial for future improvements.