208 - Standardized Hand-Off Tool for Perioperative Patients

Description: This evidence-based practice (EBP) project explores the impact of implementing a standardized handoff tool to improve communication during the perioperative transition of pediatric and adult intensive care unit (ICU) patients at a large level-2 metropolitan hospital. Ineffective handoffs have been identified by The Joint Commission as a significant contributor to adverse patient outcomes, particularly in vulnerable populations such as pediatric and critically ill patients. At the project site, ICU and pediatric providers reported dissatisfaction with existing handoff processes and expressed the need for more structured communication tools. The primary objective of this project is to assess whether a standardized handoff tool, adapted from the facility's existing cardiovascular ICU format and guided by the ISBARQ framework (Introduction, Situation, Background, Assessment, Recommendation, Questions), can improve communication quality during perioperative handoffs.

The project design is grounded in Lewin's Change Theory and employs a pre- and post-intervention methodology. Following IRB approval, baseline handoff data are collected using the Handoff Clinical Evaluation Exercise (CEX) scale, a validated instrument for assessing communication effectiveness during transitions of care. During the intervention phase, providers receive structured training on using the ISBARQ-based handoff tool. The tool is deployed across perioperative areas and non-cardiac ICUs, and a three-month implementation period follows. Post-intervention communication data are again measured using the Handoff CEX scale.

Quantitative data will be analyzed using SPSS software. Pre- and post-implementation scores will be compared using Mann-Whitney U or unpaired t-tests depending on data distribution. Demographic variables such as patient type (pediatric vs. adult ICU) and handoff direction (OR to ICU, ICU to OR) will be analyzed using frequency distributions and descriptive statistics. The primary outcome is improvement in handoff communication quality, as indicated by higher post-intervention CEX scores. This project also monitors adherence and identifies barriers to implementation, such as provider resistance and logistical challenges.

By integrating a structured handoff process into perioperative workflows, this project seeks to improve patient safety, reduce omission errors, and enhance interprofessional collaboration. If effective, the tool may be expanded to other units within the health system. This concept poster serves as a preliminary overview of the project's rationale, methodology, and implementation strategy prior to final results collection.