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A Model for a Standardized and Sustainable Pediatric Anesthesia-Intensive Care Unit Hand-Off Process.

Priti G Dalal1, Theodore J Cios1, Theodore K M DeMartini2

  • 1Departments of Anesthesiology and Peri-Operative Medicine, Penn State Health Milton S Hershey Medical Center, Penn State Health Children's Hospital, Hershey, PA 17033, USA.

Children (Basel, Switzerland)
|September 9, 2020
PubMed
Summary

Standardizing the pediatric anesthesia to intensive care unit (ICU) hand-off process reduced missed patient information without increasing time. This improved provider satisfaction and efficiency in critical care settings.

Keywords:
anesthesiachildrenintensive carepatient hand-off

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Area of Science:

  • Pediatric Anesthesiology
  • Pediatric Intensive Care
  • Healthcare Quality Improvement

Background:

  • Effective patient hand-off between pediatric anesthesia and intensive care unit (ICU) teams is crucial for patient safety and staff satisfaction.
  • Current hand-off protocols may lead to errors and decreased satisfaction.
  • Standardization aims to optimize information exchange during critical care transitions.

Purpose of the Study:

  • To standardize the hand-off process for pediatric patients transferring from anesthesia to the ICU.
  • To evaluate the impact of a standardized hand-off on provider satisfaction, efficiency, and sustainability.
  • To assess the long-term effectiveness of the improved hand-off procedure.

Main Methods:

  • A multidisciplinary team developed and implemented a standardized hand-off process for anesthesia-ICU transfers.
  • Pre-implementation and two post-implementation (6 months, >2 years) surveys assessed staff satisfaction.
  • Audits were conducted to evaluate the quality and sustainability of the hand-off process.

Main Results:

  • The time for sign-out remained consistent (median 5-6 minutes) post-standardization.
  • A significant reduction in missed information (airway, ventilation, medications, etc.) was observed (p ≤ 0.001).
  • Provider perception of areas for improvement decreased significantly over time (78.4% pre-implementation to 49.2% >2 years post-implementation).

Conclusions:

  • A standardized, interactive hand-off process enhances efficiency and staff satisfaction in pediatric ICUs.
  • The improved process significantly decreases the rate of missed critical patient information.
  • These benefits are achieved without increasing the duration of the hand-off procedure.