Evaluation of Intraoperative Hand-Off Frequency, Duration, and Context: A Mixed Methods Analysis.
J Surg Res
; 256: 124-130, 2020 12.
Article
en En
| MEDLINE
| ID: mdl-32688079
ABSTRACT
BACKGROUND:
Hand-offs in the operating room contribute to poor communication, reduced team function, and may be poorly coordinated with other activities. Conversely, they may represent a missed opportunity for improved communication. We sought to better understand the coordination and impact of intraoperative hand-offs.METHODS:
We prospectively audio-video (AV) recorded 10 operations and evaluated intraoperative hand-offs. Data collected included percentage of time team members were absent due to breaks, relationships between hand-offs and intraoperative events (incision, surgical counts), and occurrences of simultaneous hand-offs. We also identified announcement that a hand-off had occurred and anchoring, in which team members not involved in the hand-off participated and provided information.RESULTS:
Spanning 2919 min of audio-video data, there were 74 hand-offs (range, 4-14 per case) totaling 225.2 min, representing 7.7% of time recorded. Thirty-two (45.1%) hand-offs were interrupted or delayed because of competing activities; eight hand-offs occurred during an instrument or laparotomy pad count. Six cases had simultaneous hand-offs; two cases had two episodes of simultaneous hand-offs. Eight hand-offs included an announcement. Seven included anchoring. Evaluating both temporary and permanent hand-offs, one or more original team members was absent for 40.7% of time recorded and >one team member was absent for 20.5% of time recorded.CONCLUSIONS:
Intraoperative hand-offs are frequent and not well coordinated with intraoperative events including counts and other hand-offs. Anchoring and announced hand-offs occurred in a small proportion of cases. Future work must focus on optimizing timing, content, and participation in intraoperative hand-offs.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Quirófanos
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Grupo de Atención al Paciente
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Pase de Guardia
/
Cuidados Intraoperatorios
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Qualitative_research
Límite:
Humans
Idioma:
En
Año:
2020
Tipo del documento:
Article