Implementation of a standardized handover checklist for intraoperative anesthesia care transition attenuates burnout among anesthesiologists and improves postoperative outcomes of patients undergoing major surgery , both of which benefit the quality of patient care and the development of anesthesiology.
Many retrospective studies have demonstrated that among adults undergoing major surgery, complete handover of intraoperative anesthesia care compared with no handover was associated with a higher risk of adverse postoperative outcomes. Anesthesiologists keeping on working without handovers may experience symptoms of burnout which do not only pose a threat to the mental and physical health of the anesthesiologist, but also result in sub-optimal safety care of patients. Poor-quality handover without standardized processes can lead to diagnostic and therapeutic delays and precipitate adverse events. An improved system of anesthesia standardized handovers using a checklist would improve transfer of information and professional responsibility and therefore lead to the improvement of patient safety as well as burnout among anesthesiologists. Thus it is urgent to develop a standardized handover checklist for intraoperative anesthesia care to improve postoperative outcome of patients.
Study Type
OBSERVATIONAL
Enrollment
3,342
Following a review of relevant literatures and guidelines, a checklist consisting of the various key items necessary for giving continuing and safe intraoperative patient care was designed and validated by anesthesia residents and staff. Following 2-week to 1-month baseline data collection, each anesthesiologists and anesthesia residents in participating hospitals were asked to implement the safe-anesthesia checklist to improve practice over another 2-week to 1-month period. The checklist consists of an oral confirmation and closed-loop communication between the primary anesthesiologist and the replacement anesthesiologist. Evaluation of the effect of implementation of a standardized checklist during anesthesia care handover on patient safety during follow-up.
Incidence of a composite of all-cause death, hospital readmission, or major postoperative complications
The primary outcome that will be measured is a composite of all-cause death, hospital readmission, or major postoperative complications, all within 30 days post surgery
Time frame: 30 days
Incidence of 7 day-, 30 day-, 90 day- and inhospital mortality
7/30/90-day mortality, inhospital mortality
Time frame: 7/30/90 day
Incidence of major complications
Postoperative major complications, defined by International Classification of Diseases, Tenth Revision (ICD-10) diagnostic codes
Time frame: 30 days
Incidence of ICU admission post surgery
Incidence of postoperative intensive care unit (ICU) admission, ,within 30 days post surgery
Time frame: 30 days
The time of hospital length of stay (LOS)
Hospital length of stay (LOS)
Time frame: up to 30 days
Incidence of emergency department (ED) visits
Emergency department (ED) visits within 90 days of the index surgery
Time frame: 90 days
Any medical cost during hospital stay
Any medical cost during hospital stay
Time frame: up to 90 days
Ventilation time within postoperative 30 days
Ventilation time within postoperative 30 days
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Time frame: Up to 30 days
Anaesthetic resuscitation time
Anaesthetic resuscitation time after the surgery is completed
Time frame: Up to 24 hours