207 - SBAR Handoff to Enhance Communication in Local Anesthetic Handoffs

Description: This quality improvement project, titled Enhancing Communication in Local Anesthetic Handoffs: Implementation of an SBAR-Based Handoff Form, addresses a critical patient safety concern at a level-2 hospital in West Central Florida: miscommunication regarding local anesthetic dosing during the perioperative period. The study question guiding this initiative is: In adult surgical patients receiving local anesthetics, does implementing a standardized SBAR handoff tool, compared to no standard handoff, improve communication among perioperative providers within three months? Given the high volume of nerve blocks performed at the institution in orthopedic and bariatric populations, the risk of Local Anesthetic Systemic Toxicity (LAST) is elevated, underscoring the need for structured, interdisciplinary communication.

The design of this project follows the Plan-Do-Study-Act (PDSA) framework, promoting iterative cycles of planning, implementation, evaluation, and refinement. Initially, baseline data will be collected via staff surveys assessing current communication practices. Next, the SBAR handoff form, developed specifically for tracking local anesthetic administration, will be introduced through targeted staff education. The tool will then be integrated into clinical workflows for all applicable surgical cases. Pre- and post-intervention data will be collected over a three-month period to evaluate the tool’s impact on communication quality and staff satisfaction.

The methodology includes the use of the Handoff Clinical Evaluation Exercise (CEX), a validated instrument measuring domains such as organization, content accuracy, communication, and clinical judgment. CEX forms will be completed by both the sender and receiver after each handoff. Additional data points, such as patient weight, type of local anesthetic, and calculated maximum safe dose, will be extracted from the SBAR handoff form. Quantitative data will be analyzed using SPSS software with statistical significance set at α < 0.05. The expected outcome is improved communication and reduced variability in local anesthetic dosing documentation. This initiative aims to strengthen perioperative team collaboration, prevent LAST, and establish a sustainable, standardized handoff practice that supports safe, high-quality anesthesia care.