Clinician perceptions of operating room to intensive care unit handoffs and implications for patient safety: a qualitative study

• Published in: The American journal of surgery Vol. 210; no. 4; pp. 629 - 635
• Main Authors: McElroy, Lisa M., M.D., M.S, Macapagal, Kathryn R., Ph.D, Collins, Kelly M., M.D, Abecassis, Michael M., M.D., M.B.A, Holl, Jane L., M.D., M.P.H, Ladner, Daniela P., M.D., M.P.H, Gordon, Elisa J., Ph.D., M.P.H
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2015; Elsevier Limited
• Subjects: Attitude of Health Personnel; Checklist; Communication; Critical care; Grounded Theory; Humans; Intensive Care Units; Interprofessional Relations; Operating Rooms; Patient Handoff; Patient Safety; Patient Transfer; Postoperative period; Qualitative methods; Qualitative Research; Quality improvement; Research methodology; Studies; Surgery; Critical care; Patient safety; Qualitative methods; Quality improvement; Patient handoff
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2015.05.008

Abstract Background Operating room (OR) to the intensive care unit (ICU) handoffs are known sources of medical error, yet little is known about the relationship between process failures and patient harm. Methods Interviews were conducted with clinicians involved in the OR-to-ICU handoff to characterize the relationship between handoff process failures and patient harm. Qualitative analysis was used to inductively identify key themes. Results A total of 38 interviews were conducted. Dominant themes included early communication from the OR to the ICU, team member participation in the handoff, and relationships between clinicians; clinician perspectives varied depending substantially on role within the team. Conclusions The findings suggest that ambiguous roles and conflicting expectations of team members during the OR-to-ICU handoff can increase risk of patient harm. Future studies should investigate early postoperative ICU care as outcome markers of handoff quality and the effect of interprofessional education on clinician adherence to interventions.