title: A Simple, Visually Oriented Communication System to Improve Postoperative Care Following Microvascular Free Tissue Transfer: Development, Results, and Implications.
abstract: Background Communication, particularly transmission of information between the surgical and nursing teams, has been identified as one of the most crucial determinants of patient outcomes. Nonetheless, transfer of information among and between the physician and nursing teams in the immediate postoperative period is often informal, verbal, and inconsistent. Methods An iterative process of multidisciplinary information gathering was undertaken to create a novel postoperative communication system (the "Pop-form"). Once developed, nurses were surveyed on multiple measures regarding the perceived likelihood that it would improve their ability to provide directed patient care. Data were quantified using a Likert scale (0-10), and statistically analyzed. Results The Pop-form records and transfers operative details, specific anatomic monitoring parameters, and senior physician contact information. Sixty-eight nurses completed surveys. The perceived usefulness of different components of the Pop-form system was as follows: 8.9 for the description of the procedure; 9.3 for the operative diagram; 9.4 for the monitoring details and parameters; and 9.4 for the direct contact information for the appropriate surgical team member. All respondents were in favor of widespread adoption of the Pop-form. Conclusion This uniform, visual communication system requires less than 1 minute to compose, yet formalizes and standardizes inter-team communication, and therefore shows promise for improving outcomes following microvascular free tissue transfer. We believe that this simple, innovative communication tool has the potential to be more broadly applied to many other health care settings.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medical College, New York, New York.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Henderson
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medical College, New York, New York.
authors.forename: Wilmina
authors.initials: W
authors.lastname: Landford
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medical College, New York, New York.
authors.forename: Jason
authors.initials: J
authors.lastname: Gardenier
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medical College, New York, New York.
authors.forename: David M
authors.initials: DM
authors.lastname: Otterburn
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Columbia University Medical Center, New York, New York.
authors.forename: Christine H
authors.initials: CH
authors.lastname: Rohde
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medical College, New York, New York.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Spector
mesh_terms: D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D010348:Patient Care Team; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D011785:Quality Assurance, Health Care; D058996:Quality Improvement; D019651:Plastic Surgery Procedures / Q000379:methods*