STEPP IN: A Multicenter Quality Improvement Collaborative Standardizing Postoperative Handoffs.

Area of Science:

• Neonatal surgery
• Quality improvement science
• Patient safety

Background:

• Postoperative handoffs in neonatal intensive care units (NICUs) are critical for patient safety.
• Care failures during these transitions can lead to adverse outcomes for surgical neonates.
• Standardized communication processes are essential to mitigate these risks.

Purpose of the Study:

• To reduce care failures by 30% in surgical NICU patients.
• To implement and sustain standardized communication processes for postoperative handoffs.
• To decrease both respiratory and non-respiratory communication failures.

Main Methods:

• A collaborative quality improvement initiative involving 19 Children's Hospitals Neonatal Consortium centers.
• Implementation of evidence-based clinical practice recommendations and a standardized handoff communication tool.
• Data collection over 8 months baseline, 12 months action phase, and 7 months sustain phase, monitoring process measures and handoff satisfaction.

Main Results:

• Communication failures specific to respiratory care decreased by 73.2%.
• All other communication care failures decreased by 49.4%.
• 84% of participants reported high satisfaction with the handoff process, with increased tool compliance and decreased interruptions.

Conclusions:

• Team engagement in a quality improvement framework positively impacted perioperative handoffs for high-risk surgical neonates.
• The study successfully reduced postoperative care failures, demonstrating improved patient care.
• High provider satisfaction was maintained throughout the initiative.