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Pilot study to develop a pre-operative “Cardiothoracic Clinical Handover Tool” and its effect on handover quality

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Abstract

Background

Clinical handover is an essential step in the surgical patient’s hospital journey, but one that is not without risk. Within cardiothoracic surgery, endeavours to protocolise post-operative handover from cardiac theatre to cardiac intensive care units have resulted in enhanced patient safety, but little to no effort has focused on the pre-operative setting and the dissemination of information throughout the surgical team.

Methods

We designed a pre-post study examining the quality of pre-operative cardiothoracic patient handovers before and after the introduction of an intra-departmentally designed “Cardiothoracic Clinical Handover Tool” based on the Royal College of Surgeons of England’s guidelines for “Safe Handover”.

Results

Forty clinical handovers were assessed in each arm of the study. Handover quality improved from a score of 63.75% to 88.57% (p = < 0.001). This prolonged handover duration from a mean of 72.1 to 102.4 seconds per case (p = 0.003). Interruptions occurred in 27.5% of pre- and 25% of post-intervention handovers. Interruptions resulted in increased handover duration in both pre- and post-intervention groups (114.6 vs 77.7 seconds, p = 0.012) and poorer quality handovers in the pre-intervention group (51.28% vs 68.42%, p = 0.03) but failed to impact handover quality in the post-intervention group (88.57% vs 88.57%, p = 1).

Conclusions

Clinical handover tools have the potential to enhance the quality of pre-operative handover and protect against poor handover practices such as interruptions, safe-guarding patient welfare. We provide the first cardiothoracic specific pre-operative handover tool based on the RCSE guidelines.

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Cork University Hospital, Wilton, Cork, Ireland

    John David Kehoe, Patrick Higgins, Sean Barrett & John Hinchion

  2. University College Cork, College Road, Cork, Ireland

    John David Kehoe & John Hinchion

Authors
  1. John David Kehoe
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  2. Patrick Higgins
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  3. Sean Barrett
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  4. John Hinchion
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Corresponding author

Correspondence to John David Kehoe.

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Ethics approval

This study was approved by the Quality and Patient Safety Department of our institution.

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The authors declare no competing interests.

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Kehoe, J.D., Higgins, P., Barrett, S. et al. Pilot study to develop a pre-operative “Cardiothoracic Clinical Handover Tool” and its effect on handover quality. Ir J Med Sci 193, 1125–1129 (2024). https://doi.org/10.1007/s11845-023-03585-2

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  • DOI: https://doi.org/10.1007/s11845-023-03585-2

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