Intraoperative Handover Checklist of Anesthesia Care Improves Outcomes Among Patients Undergoing Major Surgery
Study Details
Study Description
Brief Summary
Implementation of a standardized handover checklist for intraoperative anesthesia care transition attenuates burnout among anesthesiologists and improves postoperative outcomes of patients undergoing major surgery , both of which benefit the quality of patient care and the development of anesthesiology.
| Condition or Disease | Intervention/Treatment | Phase |
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Detailed Description
Many retrospective studies have demonstrated that among adults undergoing major surgery, complete handover of intraoperative anesthesia care compared with no handover was associated with a higher risk of adverse postoperative outcomes. Anesthesiologists keeping on working without handovers may experience symptoms of burnout which do not only pose a threat to the mental and physical health of the anesthesiologist, but also result in sub-optimal safety care of patients. Poor-quality handover without standardized processes can lead to diagnostic and therapeutic delays and precipitate adverse events. An improved system of anesthesia standardized handovers using a checklist would improve transfer of information and professional responsibility and therefore lead to the improvement of patient safety as well as burnout among anesthesiologists. Thus it is urgent to develop a standardized handover checklist for intraoperative anesthesia care to improve postoperative outcome of patients.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| baseline or control group All participant anesthesiologists do intraoperative handover of anesthesia care according to a usual process or without checklist for 2-week to 1-month baseline data collection. |
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| Checklist group All participant anesthesiologists do intraoperative handover of anesthesia care by using a standardized handover checklist for another 2-week to 1-month data collection. |
Device: standardized handover checklist
Following a review of relevant literatures and guidelines, a checklist consisting of the various key items necessary for giving continuing and safe intraoperative patient care was designed and validated by anesthesia residents and staff. Following 2-week to 1-month baseline data collection, each anesthesiologists and anesthesia residents in participating hospitals were asked to implement the safe-anesthesia checklist to improve practice over another 2-week to 1-month period. The checklist consists of an oral confirmation and closed-loop communication between the primary anesthesiologist and the replacement anesthesiologist. Evaluation of the effect of implementation of a standardized checklist during anesthesia care handover on patient safety during follow-up.
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Outcome Measures
Primary Outcome Measures
- Incidence of a composite of all-cause death, hospital readmission, or major postoperative complications [30 days]
The primary outcome that will be measured is a composite of all-cause death, hospital readmission, or major postoperative complications, all within 30 days post surgery
Secondary Outcome Measures
- Incidence of 7 day-, 30 day-, 90 day- and inhospital mortality [7/30/90 day]
7/30/90-day mortality, inhospital mortality
- Incidence of major complications [30 days]
Postoperative major complications, defined by International Classification of Diseases, Tenth Revision (ICD-10) diagnostic codes
- Incidence of ICU admission post surgery [30 days]
Incidence of postoperative intensive care unit (ICU) admission, ,within 30 days post surgery
- The time of hospital length of stay (LOS) [up to 30 days]
Hospital length of stay (LOS)
- Incidence of emergency department (ED) visits [90 days]
Emergency department (ED) visits within 90 days of the index surgery
- Any medical cost during hospital stay [up to 90 days]
Any medical cost during hospital stay
- Ventilation time within postoperative 30 days [Up to 30 days]
Ventilation time within postoperative 30 days
- Anaesthetic resuscitation time [Up to 24 hours]
Anaesthetic resuscitation time after the surgery is completed
Eligibility Criteria
Criteria
Inclusion Criteria:
- Adult patients aged 18 years and older undergoing major surgeries requiring a hospital stay of at least 1 night are enrolled in this study.
Exclusion Criteria:
- Adult patients aged less than 18 years undergoing major surgeries and were not requiring a hospital stay of at least 1 night are excluded.
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- First Affiliated Hospital of Zhejiang University
- Zhejiang Provincial Tongde Hospital
Investigators
- Principal Investigator: Fang Xiangming, first affilated hospital of zhejiang university
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- xfang