PERIOPERATIVE HAND OFF: A QUALITY IMPROVEMENT PROJECT

The peri-operative arena is a complex environment where multiple tasks occur such as preparing patients for surgery, monitoring patients for complications, and ensuring patient safety during transition of care. This management process requires continuous communication between providers to promote safe and effective care. Studies suggest that a standardized process of communicating specific information and data may optimize patient care during transition (De Vries et al., 2010). A quality improvement (QI) project was conducted in an outpatient surgery setting. Its focus was to develop, implement, and evaluate a handoff tool that would serve as a checklist for the pre-operative and intra-operative nurses during transition of care. A 3-phase design was used. First, pre-data collection of errors was identified from occurrence reports. Second, a Pre-operative Checklist Tool (POCT) was developed and its content validity established. Third, the POCT was evaluated for reliability, effectiveness, compliance, and ease of use. Results reflected that 76% of nurses surveyed reported that the POCT contained appropriate safety components. Most participants (78%) believed that the POCT would improve communication. Prior to POCT use, 14 monthly occurrence reports revealed that 1 to 3 negative clinical events occurred monthly. During the 1-month pilot and four months afterwards, there were no reported negative clinical events. This QI project supported the benefits of using a standardized communication process during care perioperative transitions