An evaluation of information transfer through the continuum of surgical care: a feasibility study.
OBJECTIVE
To evaluate information transfer and communication (ITC) across the surgical care pathway with the use of Information Transfer and Communication Assessment Tool for Surgery (ITCAS).


BACKGROUND
Communication failures are the leading cause of surgical errors and adverse events. It is vital to assess the ITC across the entire surgical continuum of care to understand the process, to study teams, and to prioritize the phases for intervention.


METHODS
Twenty patients undergoing major gastrointestinal procedures were followed through their entire surgical care, and ITC process was assessed using ITCAS. ITCAS consisted of 4 checklists for 4 phases of the surgical care.


RESULTS
ITC failures are distributed across the entire surgical continuum of care. Preprocedural teamwork and postoperative handover phases have the maximum number of ITC failures (61.7% and 52.4%, respectively). Moreover, it was found that information degrades as it crosses from one phase to another. Of patients, 75% had clinical incidents or adverse events because of ITC failures.


CONCLUSIONS
The study demonstrated that ITC failures are ubiquitous across surgical care pathway and there is an imminent need to modify current ITC practices. Standardization of ITC through use of checklists, protocols, or information technology is essential to reduce these communication failures.
Nagpal
Kamal
K
Department of Biosurgery and Surgical Technology, Centre for Patient Safety & Surgical Quality, Imperial College, London, United Kingdom.
Vats
Amit
A
Ahmed
Kamran
K
Vincent
Charles
C
Moorthy
Krishna
K
D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards*; D013505:Digestive System Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D019451:Information Management / Q000379:methods*; D033183:Interdisciplinary Communication; D007400:Interprofessional Relations; D007407:Interviews as Topic; D008297:Male; D019300:Medical Errors / Q000517:prevention & control*; D008875:Middle Aged; D020380:Needs Assessment; D010348:Patient Care Team / Q000458:organization & administration; D011785:Quality Assurance, Health Care; D018570:Risk Assessment; D017751:Safety Management