title: Handoff checklists improve the reliability of patient handoffs in the operating room and postanesthesia care unit.
abstract: BACKGROUND
  Ineffective communications among healthcare providers are common and increases the risk of medical errors. During the perioperative period, multiple handoffs occur within a short period of time, and failure to convey important patient information can compromise safety. We used quality improvement methodology to improve the reliability of our handoffs in the operating room and postanesthesia care unit (PACU).
  
  
  METHODS
  Two quality improvement teams were developed to focus on the intraoperative and postanesthesia handoff processes. Key driver diagrams and 'smart aims' were developed for each process based on feedback from anesthesia and nursing staff, and handoff checklists were developed and revised using multiple plan-do-study-act cycles. Data on the reliability of the handoff processes were obtained prior to initiation of the projects and throughout the 6-month project period.
  
  
  RESULTS
  The reliability of intraoperative anesthesia handoffs improved from 20% to 100% with use of the intraoperative handoff checklist. Similarly, with the introduction of a standardized PACU checklist, the reliability of PACU handoffs improved from 59% to greater than 90%.
  
  
  CONCLUSIONS
  We utilized quality improvement methodology to develop and implement standardized checklists for handoffs of care in the operating room and PACU. Acceptance of and adherence to the standardized handoff protocols dramatically increased the quality and reliability of our handoff process.
authors.affiliation: Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. anne.boat@cchmc.org
authors.forename: Anne C
authors.initials: AC
authors.lastname: Boat
authors.forename: James P
authors.initials: JP
authors.lastname: Spaeth
mesh_terms: D000758:Anesthesia; D000762:Anesthesia Recovery Period; D057189:Checklist / Q000379:methods*; D002648:Child; D003266:Continuity of Patient Care; D006776:Hospitals, Pediatric / Q000458:organization & administration; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D009873:Operating Rooms / Q000458:organization & administration*; D062209:Patient Handoff / Q000458:organization & administration*; D058996:Quality Improvement; D011997:Recovery Room / Q000458:organization & administration*; D015203:Reproducibility of Results