Patient Transitions and Handovers Across the Continuum of Surgical Care



Modern surgical care involves numerous care transitions, including (1) preoperative transitions into the operating room (OR) (a) surgery is scheduled, (b) sign in, time-out, sign out), (2) postoperative transitions (a) OR to intensive care unit (ICU) or postanesthesia care unit (PACU), (b) ICU or PACU to the floor), and (3) (a) discharge transitions and (b) outpatient follow-up. The effective transfer of responsibility for the care of the patient from one healthcare provider to another during each of these transitions is crucial to providing safe, high-quality patient care. Ineffective transition processes lead to fragmented communication and clinical understanding and can result in delays, errors, and substantial patient harm. This chapter will discuss recent advances and remaining challenges in improving the quality of transitions to ensure patient safety during the major phases of surgical care, from surgical scheduling to discharge. New more comprehensive models involving multimodal interventions such as enhanced recovery after surgery and the perioperative surgical home are emerging that will redefine the way surgical care is delivered, which are largely focused on improving the many patient care transitions involved in surgical care.


Patient safety Care transitions Handover Patient handoff Clinical communication Surgical safety 


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Center for Healthcare Studies, Institute for Public Health and Medicine, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  2. 2.Department of SurgeryMedical College of Wisconsin and Affiliated HospitalsMilwaukeeUSA

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