title: Clinician perceptions of operating room to intensive care unit handoffs and implications for patient safety: a qualitative study.
abstract: BACKGROUND
  Operating room (OR) to the intensive care unit (ICU) handoffs are known sources of medical error, yet little is known about the relationship between process failures and patient harm.
  
  
  METHODS
  Interviews were conducted with clinicians involved in the OR-to-ICU handoff to characterize the relationship between handoff process failures and patient harm. Qualitative analysis was used to inductively identify key themes.
  
  
  RESULTS
  A total of 38 interviews were conducted. Dominant themes included early communication from the OR to the ICU, team member participation in the handoff, and relationships between clinicians; clinician perspectives varied depending substantially on role within the team.
  
  
  CONCLUSIONS
  The findings suggest that ambiguous roles and conflicting expectations of team members during the OR-to-ICU handoff can increase risk of patient harm. Future studies should investigate early postoperative ICU care as outcome markers of handoff quality and the effect of interprofessional education on clinician adherence to interventions.
authors.affiliation: Center for Healthcare Studies and Center for Education in Health Sciences, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University Transplant Outcomes Research Collaborative, Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address: lisa.mcelroy@northwestern.edu.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: McElroy
authors.affiliation: Center for Healthcare Studies and Center for Education in Health Sciences, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Kathryn R
authors.initials: KR
authors.lastname: Macapagal
authors.affiliation: Section of Transplantation, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Collins
authors.affiliation: Northwestern University Transplant Outcomes Research Collaborative, Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Abecassis
authors.affiliation: Center for Healthcare Studies and Center for Education in Health Sciences, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University Transplant Outcomes Research Collaborative, Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Jane L
authors.initials: JL
authors.lastname: Holl
authors.affiliation: Center for Healthcare Studies and Center for Education in Health Sciences, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University Transplant Outcomes Research Collaborative, Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Daniela P
authors.initials: DP
authors.lastname: Ladner
authors.affiliation: Center for Healthcare Studies and Center for Education in Health Sciences, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University Transplant Outcomes Research Collaborative, Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Elisa J
authors.initials: EJ
authors.lastname: Gordon
mesh_terms: D001291:Attitude of Health Personnel; D057189:Checklist; D003142:Communication; D066296:Grounded Theory; D006801:Humans; D007362:Intensive Care Units; D007400:Interprofessional Relations; D009873:Operating Rooms; D062209:Patient Handoff; D061214:Patient Safety; D010360:Patient Transfer; D036301:Qualitative Research
keywords: Critical care; Patient handoff; Patient safety; Qualitative methods; Quality improvement