Clinician perceptions of operating room to intensive care unit handoffs and implications for patient safety: a qualitative study

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• 作者：Lisa M. McElroy ; M.D. ; M.S.^a ; ^b ; ^{lisa.mcelroy@northwestern.edu" class="auth_mail" title="E-mail the corresponding author} ; Kathryn R. Macapagal ; Ph.D.^a ; ^c ; Kelly M. Collins ; M.D.^d ; Michael M. Abecassis ; M.D. ; M.B.A.^b ; Jane L. Holl ; M.D. ; M.P.H.^a ; ^b ; Daniela P. Ladner ; M.D. ; M.P.H.^a ; ^b ; Elisa J. Gordon ; Ph.D. ; M.P.H.^a ; ^b
• 关键词：Critical care ; Patient handoff ; Qualitative methods ; Patient safety ; Quality improvement
• 刊名：The American Journal of Surgery
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：210
• 期：4
• 页码：629-635
• 全文大小：242 K

文摘

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.