A standardized handoff tool was implemented between the operating room and pediatric post-anesthesia care unit (PACU) at a hospital to improve communication. Prior to the tool, a review found miscommunication was responsible for up to 85% of hospital errors. Nurses analyzed various handoff methods and created a questionnaire to evaluate current practice. Data collected before and after implementing the tool showed completion of handoff elements increased, particularly around patient allergies, procedures, medications and history. The standardized tool improved interdisciplinary communication within one month and helps ensure efficient, safe and quality patient care during handoffs.

1. INTRODUCTION
REFERENCES
METHOD
RESULTS
CONCLUSIONS
ACKNOWLEDGEMENTS
Improving Pediatric Handover in a Pediatric Daystay Surgery Center
Michelle Whitney, RN, MSN/Ed, CPN, CLNC, Dusti Wells, RN, & Kim Reed, RN
Department of Perianesthesia and Division of Nursing
In unit Clinical Practice, nurses identified the lack of
appropriate exchange of pertinent patient information at
handoff from the Operating room. “Miscommunication was
reported by the Joint Commission on the Accreditation of
Healthcare Organizations to be responsible for up to 85% of
hospital sentinel events” (Boat and Spaeth, 2013). A
breakdown of communication can lead to adverse patient
outcomes including: decrease quality of care, increase length
of stay, and injury or harm, which may lead to overall increase
cost of care.
Will a handoff tool in the pediatric daystay surgery population
improve interdisciplinary communication and improve handoff
practice to provide best quality care, increase patient safety,
and efficiency?
• A literature review of perioperative, anesthesia and O.R.
journals using key words “handoff communication” was
completed.
• An analysis done of various tools used for handoff
communication from various organizations.
• Created was a data collection questionnaire evaluating the
current handoff state on unit.
• Data was collected for one month without O.R. Nurse,
Anesthesia or Surgical provider awareness, June 2014.
• After data assessment, the Handoff Tool approval was
obtained by Anesthesia, O.R. and Perianesthesia leadership
for implementation and education began July 2014.
• Roll out of the handoff communication tool from OR to
Pediatric PACU began August 2014.
• Effectiveness of handoff tool utilizing the data collection
questionnaire was completed in September 2014.
• Abraham, J., Kannampallil, T.G. & Patel, V.L. (2011). Bridging gaps in
handoffs: A continuity of care based approach. Journal of Biomedical
Informatics, 45,240-254. Doi: 10.1016/j.jbi.2001.10.011
• AORN (2012) Recommendations for perioperative Patient Hand-off
http://www.aorn.org/PracticeResources/ToolKits/PatientHandOffToolKit/
• Boat, A.C. & Spaeth, J.P. (2013). Handoff checklists improve the reliability of
patient handoffs in the operating room and post anesthesia care unit.
Pediatric Anesthesia, 23, 647-654. Doi:10.111/pan.12199
• Cooper, Alecia. ( 2010). Applying evidenced-based information to improve
hand-off communication in perioperative services. The OR Connection, 18-24.
• Kalkman, C.J. (2010). Handover in the perioperative care process. Current
Opinion in Anesthesiology, 23: 749-753. Doi:10.1097/ACO.
0b013e3283405ac8
Pediatric Post Anesthesia Care Nurses and Dept. of
Perianesthesia
Utilization of a standardized handoff tool in the pediatric
daystay surgery at Baystate Medical Center improved
interdisciplinary communication within one month of
implementation.
Effective communication of patient care, improves efficiency,
safety, and quality of care to the PACU and is an integral
aspect of overall care delivered. With increasing acuity, fast
turnover of care, and high volumes, implementing a handoff
tool improves communication of pertinent information needed
to provide best practice.
Placed on
monitor
Oxygen Pt.ID
IV (hung and
running)
Allergies Weight Procedure Medications History
Pre June 2014 (n=53) 15% 33% 52% 20% 52% 32% 30% 26% 18%
Post September 2014 (n=54) 19% 28% 89% 20% 81% 44% 67% 61% 19%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
PercentageComplete
OR Nurse Handoff Communication
Airway
History
Placed on
Monitor
Oxygen Pt. ID
IV(hung
and
running)
Allergies Weight Procedure Medications History
Pre June 2014 (n=53) 77% 49% 45% 34% 58% 70% 74% 81% 85% 77%
Post September 2014 (n=54) 91% 65% 41% 63% 63% 85% 96% 89% 100% 96%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
PercentageComplete
Anesthesiologists Handoff Communication