title: Deficits in information transfer between anaesthesiologist and postanaesthesia care unit staff:  an analysis of patient handover.
abstract: BACKGROUND
  The immediate postoperative period is important, as the patient recovers from the acute derangements resulting from the surgical insult and anaesthesia. Incomplete or incorrect communication between the anaesthesiologist and the postanaesthesia care unit nurse during the transfer process may lead to dangerous clinical mistakes. The literature examining handovers from operating room to the postanaesthesia care unit is scarce.
  
  
  OBJECTIVE
  The primary objective of this study was to examine the current transfer practice through observation of handovers between the anaesthesiologists and the postanaesthesia care unit staff in order to identify data omissions. The secondary objective was to learn which data items the clinicians and nurses thought were a necessary part of the transfer process and whether this information was communicated at the time of handover.
  
  
  METHODS
  A prospective observational study.
  
  
  METHODS
  Academic hospital in Toronto, Canada.
  
  
  METHODS
  After Research Ethics Board approval, a prospective observational study was conducted at a university-affiliated teaching centre. During a 2-month period, multiple observations of patient handover were performed. The data provided were marked on a checklist. At the end of the study, participating nurses and physicians were surveyed regarding the necessity of communicating different items on the checklist.
  
  
  RESULTS
  A total of 526 transfers were observed. Of 29 data items examined, only two items (type of surgery and analgesics given) were reported in more than 90% of handovers. Only three items (difficult intubation, ST-wave changes and co-morbidities/healthy) were reported in more than 80% of cases. Many items deemed as needed to be reported by the participants in the study were not communicated.
  
  
  CONCLUSIONS
  This study demonstrates that the handover process is inconsistent and in some cases information defined as important by the physicians and the nurses is not transferred. Further studies need to investigate whether a handover protocol leads to a minimisation of omissions in information transfer.
authors.affiliation: Department of Anaesthesia and Pain Management, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada. naveed.siddiqui@uhn.ca
authors.forename: Naveed
authors.initials: N
authors.lastname: Siddiqui
authors.forename: Cristian
authors.initials: C
authors.lastname: Arzola
authors.forename: Mirza
authors.initials: M
authors.lastname: Iqbal
authors.forename: Kobika
authors.initials: K
authors.lastname: Sritharan
authors.forename: Laarni
authors.initials: L
authors.lastname: Guerina
authors.forename: Frances
authors.initials: F
authors.lastname: Chung
authors.forename: Zeev
authors.initials: Z
authors.lastname: Friedman
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D000776:Anesthesiology; D003142:Communication; D003266:Continuity of Patient Care; D006801:Humans; D008875:Middle Aged; D010360:Patient Transfer; D011446:Prospective Studies; D011997:Recovery Room