The authors of an article in the June 2015 APSF Newsletter describe how they created a checklist for handoffs from the anesthesia team to the postanesthesia care unit (PACU) nurse. A major goal was to improve communication without increasing burden. After consulting the literature and anesthesia textbooks, the authors identified 42 items to consider for inclusion. They then reduced the list to include only items relevant to their institution and observed 10 PACU handoffs to identify potential missing items. The resulting checklist had 19 items, plus a final question, "Do you have any questions or concerns?" The 11 patient-related items included patient identification, physical status, and surgical or anesthetic complications. The four procedure-related items included patient positioning and fluid management. The four medication-related items included the analgesia plan and medication due during the PACU stay. Data collectors observed 50 handoffs by residents without use of the checklist (control group). After the checklist was introduced to residents, data collectors observed 50 handoffs by residents with use of the checklist (intervention group). The percentage of items on the checklist that were discussed during handoffs increased from 52% in the control group to 70% in the intervention group. However, use of the checklist took longer: handoffs lasted 101 seconds in the control group and 126 seconds in the intervention group. In addition, only 4 of the 50 handoffs in the intervention group addressed all of the items on the checklist.

HRC Recommends: Organizations that provide surgical services may wish to evaluate the effectiveness of postoperative handoffs between the anesthesia team and the PACU nurse. They may then consider strategies for improvement, which may involve the use of tools such as checklists. Additional guidance is available in the HRC resources listed to the right, the American Society of Anesthesiologists' standards for postanesthesia care, and the American Society of PeriAnesthesia Nurses' practice recommendation on handoffs.