title: Improving postoperative handover from anaesthetists to non-anaesthetists in a children's intensive care unit: the receiver's perception.
abstract: BACKGROUND
  The efficiency of postoperative handover of paediatric patients to the children's intensive care unit (CICU) varies according to institutions, clinical setup and workflow. Reorganisation of handover flow based on findings from observational studies has been shown to improve the efficiency of information transfer. This study aimed to evaluate a new handover process based on recipients' perceptions, focusing on completeness and comprehensiveness of verbal communication, and the usability of a situation, background, assessment and recommendation (SBAR) form.
  
  
  METHODS
  This was a prospective interventional study conducted in the CICU of KK Women's and Children's Hospital, Singapore. It comprised four phases: (1) evaluation of the current handover process through an audit and opinion survey; (2) development of a new handover process based on the opinion survey and hospital personnel feedback; (3) implementation; and (4) evaluation of the new handover process. The new handover process was based on a PETS (pre-handover, equipment handover, timeout and sign out) protocol with a 'single traffic communication' flow and a new SBAR handover document. It included relevant patient information, and the options 'not applicable' and 'none', to increase compliance and reduce ambiguity.
  
  
  RESULTS
  Significantly more recipients indicated that the new SBAR form was the most important handover tool and provided more useful information. Recipients' perceptions indicated improvement in information sufficiency and clarity; reduction of omission errors; and fewer inconsistencies in patient descriptions in the new process.
  
  
  CONCLUSIONS
  Dual customisation of the handover process, PETS protocol and SBAR form is necessary to meet the workflow and information demands of the receiving team.
authors.affiliation: Department of Paediatric Anaesthesia, KK Women's and Children's Hospital, Singapore.
authors.forename: Teddy Suratos
authors.initials: TS
authors.lastname: Fabila
authors.affiliation: Department of Paediatric Anaesthesia, KK Women's and Children's Hospital, Singapore.
authors.forename: Hwan Ing
authors.initials: HI
authors.lastname: Hee
authors.affiliation: Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore.
authors.forename: Rehena
authors.initials: R
authors.lastname: Sultana
authors.affiliation: Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore.
authors.forename: Pryseley Nkouibert
authors.initials: PN
authors.lastname: Assam
authors.affiliation: Department of Anaesthesia, Changi General Hospital, Singapore.
authors.forename: Anne
authors.initials: A
authors.lastname: Kiew
authors.affiliation: Children's Intensive Care Unit, KK Women's and Children's Hospital, Singapore.
authors.forename: Yoke Hwee
authors.initials: YH
authors.lastname: Chan
mesh_terms: D000758:Anesthesia; D001291:Attitude of Health Personnel; D002648:Child; D003422:Critical Care / Q000379:methods*; D006776:Hospitals, Pediatric / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units; D019300:Medical Errors / Q000517:prevention & control; D009726:Nurses; D064887:Observational Studies as Topic; D062209:Patient Handoff; D010372:Pediatrics / Q000379:methods; D011182:Postoperative Care / Q000379:methods*; D011184:Postoperative Period; D011446:Prospective Studies; D012846:Singapore; D011795:Surveys and Questionnaires
keywords: PETS protocol; SBAR form; handover process; opinion survey; paediatric