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Pilot study to develop a pre-operative "Cardiothoracic Clinical Handover Tool" and its effect on handover quality.

John David Kehoe1,2, Patrick Higgins3, Sean Barrett3

  • 1Department of Cardiothoracic Surgery, Cork University Hospital, Wilton, Cork, Ireland. Jdkehoe95@gmail.com.

Irish Journal of Medical Science
|December 8, 2023
PubMed
Summary

Implementing a new cardiothoracic handover tool significantly improved pre-operative patient information transfer quality. This standardized approach enhanced patient safety by reducing the negative impact of interruptions during clinical handover.

Keywords:
Cardiac surgeryClinical handoverQuality improvementThoracic surgery

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Area of Science:

  • Medical Sciences
  • Surgical Care
  • Patient Safety

Background:

  • Clinical handover is critical for surgical patient journeys but carries risks.
  • While post-operative handover in cardiothoracic surgery has improved safety, pre-operative information dissemination remains a challenge.
  • Effective communication throughout the surgical team is vital for patient welfare.

Purpose of the Study:

  • To evaluate the impact of a novel handover tool on pre-operative cardiothoracic patient information transfer.
  • To assess improvements in handover quality and identify changes in duration and interruptions.
  • To provide a cardiothoracic-specific pre-operative handover tool aligned with established guidelines.

Main Methods:

  • A pre-post study design was employed to assess handover quality.
  • An intra-departmentally developed "Cardiothoracic Clinical Handover Tool," based on Royal College of Surgeons of England guidelines, was introduced.
  • Forty clinical handovers were analyzed before and after the intervention.

Main Results:

  • Handover quality significantly improved from 63.75% to 88.57% post-intervention (p < 0.001).
  • Mean handover duration increased from 72.1 to 102.4 seconds (p = 0.003).
  • While interruptions still occurred, the handover tool mitigated their negative impact on quality in the post-intervention group.

Conclusions:

  • Clinical handover tools can enhance pre-operative handover quality in cardiothoracic surgery.
  • The developed tool effectively safeguards patient welfare by mitigating risks associated with poor handover practices like interruptions.
  • This study introduces the first cardiothoracic-specific pre-operative handover tool based on RCSE guidelines.