Abstract
Purpose: The purpose of this quality improvement project is to standardize the patient hand-off communication in the perioperative services department by implementing a surgery-specific hand-off communication tool for this pediatric setting.|Background: Failure to have a standardized patient hand-off leads to miscommunication and can therefore result in serious patient safety events. There is no surgery-specific hand-off communication tool that is supported or endorsed by a perioperative specialty organization. The available literature states that there is no surgery-specific communication hand-off tool. Several hand-off tools exist and have been developed by evidence-based practice, but none specifically for a surgical patient. An evidence-based hand-off tool can be modified to fit the needs of the specific population being reported on as long as the integrity of the communication tool is maintained. The Joint Commission (TJC), the World Health Organization (WHO), and The Association for Perioperative Nurses (AORN) all have a stake in improving patient hand-off communication.|Setting: The setting is a tertiary urban pediatric hospital in the surgical services department. The target population is a group of perioperative nurses in the surgical services department.|Methods: A qualitative study was conducted utilizing empirical research to identify the need for an improved pediatric hand-off communication tool that is specific to the needs of the pediatric surgical patient. An audit tool developed from key stakeholders was created and a pre-implementation survey was conducted for participants. Education was completed utilizing the Prosci Methodology for Change Management. A post-implementation audit was completed along with a post-implementation survey by the staff members of the department.|Results: A pre-implementation survey demonstrated 48% of hand-offs were received were not standardized and 76% of staff stated hand-offs between providers was not consistent. A bedside audit found 45% of hand-offs lacked appropriate patient identification. Post-implementation audit showed improvement of patient identification to 66% and the post-implementation survey showed 26% improvement in the consistency of provider report. Hand-off standardization increased by 26%.|Conclusion: Improvement in key areas was observed but significant improvement is still desired for identification of the patient as that number should be 100%. Standardization of hand-off improved but a bigger sample size is needed to determine a significant improvement. Standardization of hand-off showed improvement in all areas but more improvement is necessary to demonstrate consistency of utilizing a standardized hand-off tool.