Original Research

Implementation of a postoperative handoff protocol

J.J.N. van Der Walt, A.T. Scholl, I.A. Joubert, M.A. Petrovic
Southern African Journal of Anaesthesia and Analgesia | Vol 22, No 6 | a1003 | DOI: https://doi.org/10.1080/22201181.2016.1244317 | © 2016 J.J.N. van Der Walt, A.T. Scholl, I.A. Joubert, M.A. Petrovic | This work is licensed under Other
Submitted: 14 November 2025 | Published: 30 December 2016

About the author(s)

J.J.N. van Der Walt, Department of Anaesthesia, University of Cape Town, Cape Town, South Africa
A.T. Scholl, Business Professional, Orlando, United States
I.A. Joubert, Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa
M.A. Petrovic, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, United States; and, University of Central Florida College of Medicine, Orlando, United States

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Abstract

Background: Standardised handoff protocols have become necessary patient safety tools in the perioperative venue. In this study, the authors took a validated standardised perioperative handoff protocol and implemented it into their institution to improve the perioperative handoff communications from the cardiac operating theatres to the ICU.
Methods: This was a prospective, unblinded cross-sectional study. During a 6-week pre-intervention phase, 30 perioperative handoffs were observed and data were collected. Then a new structured hand-off protocol was implemented for one month, which focused on training all participating healthcare providers. This was followed by a post-intervention audit consisting of 30 operating room theatre-to-ICU handoffs using the same methodology as the pre-intervention period.
Results: Overall attendance significantly increased from 20 to 86.7%. The percentage of parallel conversations decreased from 100% pre-intervention to 60% post-intervention (p < 0.0001). The mean number of interruptions of the anaesthesiology handoff report decreased from 3.37 to 0.77 (p < 0.0001) and of the surgery report from 1.84 to 0.27 (p < 0.0001). Information-sharing scores improved among all handoff attendees with the Overall Information Sharing Score (OISS) increasing from 51.47 to 88.24% (p < 0.0001).
Conclusions: The implementation of a perioperative handoff protocol resulted in a drastic improvement in attendance, decrease in the number of interruptions, and improved information sharing. Future research should focus on patient-specific outcomes.

Keywords

handoffs; handover; ICU handoff; patient safety; perioperative handoff

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