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 character...

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Bibliographic Details
Published inThe American journal of surgery Vol. 210; no. 4; pp. 629 - 635
Main Authors McElroy, Lisa M., M.D., M.S, Macapagal, Kathryn R., Ph.D, Collins, Kelly M., M.D, Abecassis, Michael M., M.D., M.B.A, Holl, Jane L., M.D., M.P.H, Ladner, Daniela P., M.D., M.P.H, Gordon, Elisa J., Ph.D., M.P.H
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.10.2015
Elsevier Limited
Subjects
Attitude of Health Personnel
Checklist
Communication
Critical care
Grounded Theory
Humans
Intensive Care Units
Interprofessional Relations
Operating Rooms
Patient Handoff
Patient Safety
Patient Transfer
Postoperative period
Qualitative methods
Qualitative Research
Quality improvement
Research methodology
Studies
Surgery
Critical care
Patient safety
Qualitative methods
Quality improvement
Patient handoff
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Summary: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.
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ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2015.05.008