Checklist can improve surgical patient handoff

A surgical checklist can improve communication and reduce potential errors during patient handoffs, Medscape reports.

The protocol during the shift change encourages physicians to discuss the sickest patients first, according to Nicole Tapia, M.D., a fourth-year resident at Baylor College of Medicine in Houston, who presented her preliminary findings this week at the American College of Surgeons 2014 Clinical Congress. The protocol then calls for doctors to discuss new admissions, changes to current patients and finally to review tasks.

"This is something that can be used broadly to improve communication," Tapia said, according to Medscape.

The research team used a focus group to design a four-item checklist that involves a designated leader. The members of the focus group premarked their handoff list, moved to a quiet location and set their mobile devices to vibrate. The handoffs that used the checklist went faster and had fewer errors, according to the article.

Although the use of the checklist resulted in doctors discussing high-priority patients more often, residents told the research team that they preferred discussing patients in order of location in the hospital.

But surgical checklists don't always improve patient outcomes, according to a study published earlier in the New England Journal of Medicine. That study, as previously reported by FierceHealthcare, found the use of surgical safety checklists didn't improve operative mortality, readmission rates and emergency department visits within 30 days after discharge at Canadian hospitals.

However, a standardized communication process for patient handoffs does reduce errors, according to recent studies. One study found success in the process involves clearly defining every element of the handoff, including each interaction's intent, process, content and team leadership. In a second study researchers found medical errors dropped 45 percent when clinicians practiced giving and receiving handoffs under different clinical and real-world scenarios. Participants then learned an easy-to-remember mnemonic to ensure they verbally communicate all relevant information during the handoff. The team also restructured face-to-face handoffs to minimize interruptions and distractions.

To learn more:
- read the Medscape article

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