A Standardized Approach to Intraoperative Anesthesia Handoffs: Introducing the AMPLE Approach

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Abstract

Transfer of the care of a patient between healthcare providers occurs frequently during the perioperative course. The typical course of patient movement includes transfer from the preoperative area to the operating room to the postoperative area, patient-specific data is transferred multiple times between healthcare providers. This transfer of data is commonly referred to as a handoff. Literature consistently demonstrates that the use of a standardized checklist improves handoff communication. Despite the literature, most anesthesia practices have been slow to adopt a standardized approach to handoff communication. In this quality improvement project, a standardized checklist was developed through a literature review and expert consensus. Once the checklist was finalized, education was provided to users and it was implemented into the electronic medical record. Participants were then surveyed both pre-implementation and post-implementation to assess handoff practices. A pre- and post-implementation retrospective chart review was also conducted to assess documentation of handoff events and checklist usage. Analysis of the data demonstrates that the development and implementation of the new checklist, compared to the rudimentary checklist that was previously available, improved both documented handoff events and participant satisfaction with the handoff process. Comparing the pre- and post-implementation periods, documented intraoperative handoffs with the use of a checklist improved from less than 1% to 77%, and clinicians reported that there was a significant positive change in the handoff process when compared to the previous process without a checklist. These results, which are consistent with previous studies, suggest that the use of a simple checklist can improve handoff communication and provider satisfaction.

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DNP Project
Keywords
Checklist, Operating rooms, Patient handoff, Patient satisfaction
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