Anesthesia Handoff Tool for Reducing Postoperative Complications

Recruiting in Palo Alto (17 mi)

Overseen by Aubrey Samost-Williams, MD, MS

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Phase 2

Recruiting

Sponsor: The University of Texas Health Science Center, Houston

Disqualifiers: Organ donors

No Placebo Group

Prior Safety Data

Trial Summary

What is the purpose of this trial?

The purpose of this study is to assess the impact of a semi-structured intraoperative anesthesia handoff tool on patient outcomes and to assess the validity of the 5-Factor Perceived Shared Mental Model Scale (5-PSMMS) in a healthcare setting and whether the perception of Shared Mental Model (SMM) mediates the effect of the intraoperative handoff tool on postoperative outcomes

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment SemiStructured Intraoperative Anesthesia Handoff Tool, Structured Handoff Tool, Intraoperative Anesthesia Handoff Checklist for reducing postoperative complications?

Research shows that using structured handoff tools in anesthesia can improve communication, reduce medical errors, and enhance patient safety during transitions, as seen in studies where standardized handoff tools led to safer patient care and reduced adverse events. ^{1 2 3 4 5}

Is the Anesthesia Handoff Tool safe for use in humans?

The Anesthesia Handoff Tool is designed to improve communication during patient care transitions, which can reduce medical errors and prevent adverse events. Studies show that using standardized handoff tools can enhance safety by ensuring important patient information is accurately communicated between healthcare providers. ^{1 3 4 5 6}

How does the SemiStructured Intraoperative Anesthesia Handoff Tool differ from other treatments for reducing postoperative complications?

The SemiStructured Intraoperative Anesthesia Handoff Tool is unique because it standardizes the communication process during anesthesia handoffs, ensuring critical information like airway difficulty, medical history, and procedure details are consistently shared, which is not commonly done in current practices. ^{1 2 4 5 7}

Research Team

Aubrey Samost-Williams, MD, MS

Principal Investigator

The University of Texas Health Science Center, Houston

Eligibility Criteria

This trial is for surgical patients who could experience postoperative complications. Specific eligibility criteria are not provided, so it's unclear who exactly can participate or what conditions might prevent someone from joining.

Inclusion Criteria

I will experience a change in my anesthesia care team during my procedure.

I am scheduled for a non-heart-related surgery in the main operating room.

Exclusion Criteria

I am an organ donor declared brain dead.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Implementation of a semi-structured intraoperative anesthesia handoff tool during surgeries

Duration of surgery

Follow-up

Participants are monitored for peri-operative and post-operative complications

30 days after surgery

Treatment Details

Interventions

• SemiStructured Intraoperative Anesthesia Handoff Tool (Procedure)

Trial Overview The study is testing a new semi-structured intraoperative anesthesia handoff tool against the standard of care to see if it improves patient outcomes after surgery. It also evaluates a scale called the 5-PSMMS in healthcare settings.

Participant Groups

Group I: Epic Health Record semi-structured handoff cognitive aid Experimental Treatment 1 Intervention

Group II: Usual care Active Control 1 Intervention

Who Is Running the Clinical Trial?

The University of Texas Health Science Center, Houston

Lead Sponsor

Trials

974

Recruited

361,000+

Dr. LaTanya Love

The University of Texas Health Science Center, Houston

Interim President

MD from UT Medical Branch in Galveston

Dr. Jagat Narula

The University of Texas Health Science Center, Houston

Chief Academic Officer since 2023

MD, PhD

National Center for Advancing Translational Sciences (NCATS)

Collaborator

Trials

394

Recruited

404,000+

Dominique C. Pichard

National Center for Advancing Translational Sciences (NCATS)

Chief Medical Officer since 2023

MD

Joni L. Rutter

National Center for Advancing Translational Sciences (NCATS)

Chief Executive Officer since 2022

PhD in Pharmacology

Findings from Research

A survey of anesthesia providers revealed that 64% do not use a systematic handoff process, and 73% feel they receive inadequate information during handoffs, highlighting a significant need for improvement in communication.

The study identified key components necessary for effective anesthesia handoff, such as airway difficulty, invasive lines, medical history, and procedure details, which informed the creation of the TIME (transaction, induction, maintenance, emergence) handoff tool to enhance patient safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Needs Assessment for Development of the TIME Anesthesia Handoff Tool. Gibney, C., Lee, YM., Feczko, J., et al.[2019]

The implementation of a structured hand-off communication tool, called Perioperative PEARLS, significantly improved the effectiveness of communication during patient hand-offs in the perioperative setting, enhancing patient safety.

Post-implementation data showed that this standardized process led to quicker patient evaluations and interventions, resulting in a reduction of adverse events and a safer environment for patients after surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promoting Patient Safety With Perioperative Hand-off Communication. Robinson, NL.[2017]

A quality improvement initiative successfully implemented a standardized handoff tool for transitioning patients from the operating room to the neonatal intensive care unit (NICU), achieving 80% compliance with its use within 12 months.

The initiative improved staff experience and satisfaction during handoffs, although it struggled to maintain consistent attendance of all appropriate providers and did not fully meet goals for immediate family updates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Handoff Tool Improves Transitions from the Operating Room to the Neonatal Intensive Care Unit. Gallois, JB., Zagory, JA., Barkemeyer, B., et al.[2023]

A study of certified registered nurse anesthetists found that 81.2% do not use standardized handoff tools during temporary intraoperative handoffs, despite over half (57.1%) believing these tools should be implemented to improve communication.

Participants who used standardized handoff tools reported fewer concerns about increased handoff time as a barrier, indicating that these tools may enhance efficiency and communication during critical care transitions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Temporary Intraoperative Handoff Report Among Nurse Anesthetists: Utilization of Standardized Handoff Tools and Barriers to Implementation. Allen, R., Nemec, C., O'Guin, C., et al.[2023]

Intraoperative handovers of anesthesia care are linked to a higher risk of adverse patient outcomes, with a composite rate of postoperative mortality and major morbidity being 7.2% in handover cases compared to 6.2% in nonhandover cases, indicating an odds ratio of 1.08.

The implementation of a structured handover tool significantly reduced the odds of adverse outcomes over time, suggesting that such tools can improve patient safety during anesthesia care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Quality Improvement Initiative to Reduce Adverse Effects of Transitions of Anesthesia Care on Postoperative Outcomes: A Retrospective Cohort Study. Saha, AK., Segal, S.[2023]

In a study involving anesthesiology residents and faculty, information retention during simulated intraoperative handoffs declined significantly with each handoff, averaging a drop of 4 points per handoff on a 50-point scale.

Using a handoff tool improved information retention by nearly 7 points compared to traditional methods, although it did not prevent overall information degradation, highlighting the need for better strategies in clinical handoffs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measurement of Information Transfer During Simulated Sequential Complete Shift-to-Shift Intraoperative Handoffs. Schiavi, A., Hong Mershon, B., Gottschalk, A., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

A Needs Assessment for Development of the TIME Anesthesia Handoff Tool. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Promoting Patient Safety With Perioperative Hand-off Communication. [2017]

3. United States pubmed.ncbi.nlm.nih.gov

Handoff Tool Improves Transitions from the Operating Room to the Neonatal Intensive Care Unit. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Temporary Intraoperative Handoff Report Among Nurse Anesthetists: Utilization of Standardized Handoff Tools and Barriers to Implementation. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Improved Anesthesia Handoff After Implementation of the Written Handoff Anesthesia Tool (WHAT). [2019]

6. United States pubmed.ncbi.nlm.nih.gov

A Quality Improvement Initiative to Reduce Adverse Effects of Transitions of Anesthesia Care on Postoperative Outcomes: A Retrospective Cohort Study. [2023]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Measurement of Information Transfer During Simulated Sequential Complete Shift-to-Shift Intraoperative Handoffs. [2022]