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Handoff and Transition of Care Protocols for Critically Ill Surgical Patients: A Concise Review
Brian Chin1, Philip Lee, Caitlin Tweedie
1Author Affiliations: University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii (Mr Chin and Mr Lee); Department of Internal Medicine, Orlando Regional Medical Center, Orlando, Florida (Dr Tweedie); University of Central Florida College of Medicine, Orlando, Florida (Mr Kumar and Mr Yates); NOVA Southeastern University, Fort Lauderdale, Florida (Ms Mitha); NOVA Southeastern University, Kiran Patel College of Osteopathic Medicine, Fort Lauderdale, Florida (Ms Amin); Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, Florida (Dr Elkbuli); and Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida (Dr Elkbuli).
Objective:
This review aims to evaluate protocols for handoff and transition of care (HToC) in critically ill surgical patients, focusing on intervention strategies, provider's feedback, clinical outcomes, and barriers to effective HToC.
Data Sources:
A comprehensive search was conducted across five databases: PubMed, Google Scholar, ProQuest, Embase, and Cochrane.
Study Selection:
Studies assessing HToC protocols and interventions in critically ill adult surgical patients were included.
Data Extraction:
Twenty-nine articles were reviewed, encompassing over 3,920 handoffs and 746 provider interviews. Outcomes included effectiveness of intervention strategies, staff feedback, clinical results, and barriers to successful handoffs.
Data Synthesis:
Standardized checklists and structured workflows were the most frequently used strategies. These interventions significantly reduced handoff time and information omissions. Provider satisfaction and compliance improved, while preventable complications including drug dosing errors, allergic reactions, and pressure ulcers decreased. The most common barriers were poor communication, inconsistent provider participation, and time constraints.
Conclusion:
Implementation of standardized HToC protocols in critically ill adult surgical patients reduces information omissions and preventable complications while improving provider satisfaction. These findings underscore the value of structured HToC protocols and the need for further research into their sustainability and long-term outcomes.
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