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Communication Is Key in Surgery

Methodist Hospital (San Antonio, Texas)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic

Improved perioperative handoff

Hospital Units

Surgical Admissions Unit, Operating Room, Cardiovascular Operating Room and Post Anesthesia Care Unit

CSI Participants

Isabel Call, BSN, RN, BS
Marjorie Cortez, BSN, RN, CNOR
Lauren Elizondo, BSN, RN, BS
Gillian Parker, ASN, RN
Katie Terry, MSN, RN

Project Goals/Objectives

  1. To increase patient satisfaction and HCAHPS scores 3 percent
  2. To improve nursing perception of handoff process
  3. To improve average OR turn-around times
  4. To reduce PACU hold time 2 percent compared to previous year
  5. To maintain and improve utilization of new handoff form

Project Outcomes

  1. Increased year average NDNQI scores 4.6 percent
  2. Improved staff perception of handoff 34 percent
  3. Improved average OR turnover time 3.55 minutes
  4. Indirectly increased PACU hold times 8 minutes
  5. Increased handoff form utilization from 51 to 64 percent

Project Overview

Communication between the perioperative units has long been challenging. Throughout many years, attempts to improve handoff communication have resulted in development of various tools and inconsistent staff training, which proved to be confusing and frustrating. Lack of team cohesiveness also contributed to drops in communication. After researching handoff communication best practices and team-building tactics, we focused on creating an effective tool based on staff feedback and incorporating or removing other tools as needed.

These efforts resulted in a more efficient handoff tool that provided useful information throughout our patients’ perioperative journey while also meeting the needs of various units. Staff participation in the process improved unit collaboration, and we received unexpected positive feedback from physicians as they began to use the form as well. The increased hold times reported could be a result of the hospital census or inpatient holding unrelated to communication between the perioperative units.

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The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.