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

Lisa M. McElroy*, Kathryn R. MacApagal, Kelly M. Collins, Michael M. Abecassis, Jane L. Holl, Daniela P. Ladner, Elisa J. Gordon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)629-635
Number of pages7
JournalAmerican journal of surgery
Volume210
Issue number4
DOIs
StatePublished - Oct 1 2015

Funding

This work is funded by Agency for Healthcare Research and Quality and National Institute of Diabetes and Digestive and Kidney Diseases T32 Training Grants (McElroy 5T32HS000078-15 , T32DK077662 ).

Keywords

  • Critical care
  • Patient handoff
  • Patient safety
  • Qualitative methods
  • Quality improvement

ASJC Scopus subject areas

  • Surgery

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