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Updated: Jan 16, 2026

Intraoperative Video Consultation Following Bile Duct Transection Facilitates Direct OR Transfer for Robotic Hepaticojejunostomy at Tertiary Center
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An Operating Room to Intensive Care Unit Handoff That Is More Than a Handshake: A Quality Improvement Project.

Shannon Kirk1, Aisling Coffey, MeganLynn Duffy

  • 1Author Affiliations: Cardiothoracic Surgery, NYU Langone Health, New York, New York (Kirk, Coffey, Duffy); Cardiothoracic Surgery, NYU Langone Health, New York, New York (dos Reis); Nursing Research and Program Evaluation, NYU Langone Health, New York, New York (Dr Zavotsky); and Division of Critical Care Anesthesiology, KP-14 Cardiothoracic Unit and CVICU, Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York, New York (Dr Jan).

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Summary

Implementing a structured handoff process in the cardiothoracic intensive care unit (CTICU) improved patient transfer efficiency and effectiveness. This nurse-led initiative optimized the work environment and patient outcomes, projecting significant annual cost savings.

Keywords:
cardiothoracichandoffmultidisciplinarystaff satisfaction

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Area of Science:

  • Healthcare Management
  • Patient Safety
  • Quality Improvement

Background:

  • Effective interdisciplinary collaboration is crucial for optimal patient care, particularly in intensive care units (ICUs).
  • The patient handoff process is a critical juncture for sharing vital information that impacts patient outcomes.
  • High-Reliability Organization principles guide processes to enhance safety and efficiency in critical care settings.

Purpose of the Study:

  • To develop, implement, and evaluate a structured handoff process for the immediate postoperative recovery phase in an adult cardiothoracic intensive care unit (CTICU).
  • To enhance efficiency, effectiveness, and the work environment for patients transferred directly from the operating room (OR) to the CTICU.
  • To improve provider readiness and patient transition through standardized communication and role clarity.

Main Methods:

  • A nurse-led, 5-month quality improvement project in a CTICU at an academic medical center (AMC).
  • Development and implementation of a comprehensive handoff process, including a staff position map and a dedicated handoff tool.
  • Analysis of pre- and post-implementation unit-specific data, including staff workflow satisfaction surveys and financial impact assessments.

Main Results:

  • The structured handoff process reduced perceived OR patient turnover times and enhanced handoff efficiency and effectiveness.
  • Improved provider readiness at the point of care and a seamless transition for postoperative patients.
  • Projected annual savings of $25.5K by maintaining the arterial pressure monitoring system, avoiding interruptions.

Conclusions:

  • The implemented nurse-driven handoff process significantly improved efficiency, effectiveness, and the work environment in the CTICU.
  • Standardized communication, clear roles, and waste elimination fostered greater team confidence in safety and adaptability during handoffs.
  • Ongoing re-evaluation and multidisciplinary education are essential for sustaining improvements in patient transitions and outcomes.