Effect of standardized EHR-integrated handoff report on intraoperative communication outcomes.

anesthesia care continuity care transitions handovers surgeries

Journal

Journal of the American Medical Informatics Association : JAMIA
ISSN: 1527-974X
Titre abrégé: J Am Med Inform Assoc
Pays: England
ID NLM: 9430800

Informations de publication

Date de publication:
31 Jul 2024
Historique:
received: 13 03 2024
revised: 11 07 2024
accepted: 17 07 2024
medline: 31 7 2024
pubmed: 31 7 2024
entrez: 31 7 2024
Statut: aheadofprint

Résumé

We evaluated the effectiveness and implementability of a standardized EHR-integrated handoff report to support intraoperative handoffs. A pre-post intervention study was used to compare the quality of intraoperative handoffs supported by unstructured notes (pre) to structured, standardized EHR-integrated handoff reports (post). Participants included anesthesia clinicians involved in intraoperative handoffs. A mixed-method approach was followed, supported by general observations, shadowing, surveys, and interviews. One hundred and fifty-one intraoperative permanent handoffs (78 pre, 73 post) were included. One hundred percent of participants in the post-intervention cohort utilized the report. Compared to unstructured, structured handoffs using the EHR-integrated handoff report led to: (1) significant increase in the transfer of information about airway management (55%-78%, P < .001), intraoperative course (63%-86%, P < .001), and potential concerns (64%-88%, P < .001); (2) significant improvement in clinician satisfaction scores, with regards to information clarity and succinctness (4.5-4.7, P = .002), information transfer (3.8-4.2, P = .011), and opportunities for fewer errors reported by senders (3.3-2.5, P < .001) and receivers (3.2-2.4, P < .001); and (3) significant decrease in handoff duration (326.2-262.3 s, P = .016). Clinicians found the report implementation highly acceptable, appropriate, and feasible but noted a few areas for improvement to enhance its usability and integration within the intraoperative workflow. A standardized EHR-integrated handoff report ensures the effectiveness and efficiency of intraoperative handoffs with its structured, consistent format that-promotes up-to-date and pertinent intraoperative information transfer; reduces opportunities for errors; and streamlines verbal communication. Handoff standardization can promote safe and high-quality intraoperative care.

Identifiants

pubmed: 39081222
pii: 7724492
doi: 10.1093/jamia/ocae204
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

Joanna Abraham (J)

Department of Anesthesiology, Washington University School of Medicine, St Louis, MO 63110, United States.
Institute for Informatics, Data Science and Biostatistics, Washington University School of Medicine, St Louis, MO 63110, United States.

Christopher R King (CR)

Department of Anesthesiology, Washington University School of Medicine, St Louis, MO 63110, United States.

Lavanya Pedamallu (L)

Department of Anesthesiology, Washington University School of Medicine, St Louis, MO 63110, United States.

Mallory Light (M)

Goldfarb School of Nursing, Barnes-Jewish College, St Louis, MO 63110, United States.

Bernadette Henrichs (B)

Department of Anesthesiology, Washington University School of Medicine, St Louis, MO 63110, United States.
Goldfarb School of Nursing, Barnes-Jewish College, St Louis, MO 63110, United States.

Classifications MeSH