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Article

A Model for a Standardized and Sustainable Pediatric Anesthesia-Intensive Care Unit Hand-Off Process

1
Departments of Anesthesiology and Peri-Operative Medicine, Penn State Health Milton S Hershey Medical Center, Penn State Health Children’s Hospital, Hershey, PA 17033, USA
2
Division of Pediatric Critical Care, Department of Pediatrics, Penn State Health Children’s Hospital, Hershey, PA 17033, USA
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Division of Pediatric Cardiac Surgery, Department of Pediatrics, Penn State Health Children’s Hospital, Hershey, PA 17033, USA
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Department of Emergency Medicine, Ohio State Universirty, Columbus, OH 43210, USA
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Division of Newborn Medicine, Department of Pediatrics, Penn State Health Children’s Hospital, Hershey, PA 17033, USA
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Division of Pediatric Surgery, Department of Surgey, Penn State Health Children’s Hospital, Hershey, PA 17033, USA
*
Author to whom correspondence should be addressed.
Children 2020, 7(9), 123; https://doi.org/10.3390/children7090123
Received: 4 August 2020 / Revised: 29 August 2020 / Accepted: 1 September 2020 / Published: 3 September 2020
(This article belongs to the Special Issue Pediatric Anesthesia)
Background and Objectives: The hand-off process between pediatric anesthesia and intensive care unit (ICU) teams involves the exchange of patient health information and plays a major role in reducing errors and increasing staff satisfaction. Our objectives were to (1) standardize the hand-off process in children’s ICUs, and (2) evaluate the provider satisfaction, efficiency and sustainability of the improved hand-off process. Methods: Following multidisciplinary discussions, the hand-off process was standardized for transfers of care between anesthesia-ICU teams. A pre-implementation and two post-implementation (6 months, >2 years) staff satisfaction surveys and audits were conducted to evaluate the success, quality and sustainability of the hand-off process. Results: There was no difference in the time spent during the sign out process following standardization—median 5 min for pre-implementation versus 5 and 6 min for post-implementation at six months and >2 years, respectively. There was a significant decrease in the number of missed items (airway/ventilation, venous access, medications, and laboratory values pertinent events) post-implementation compared to pre-implementation (p ≤ 0.001). In the >2 years follow-up survey, 49.2% of providers felt that the hand-off could be improved versus 78.4% in pre-implementation and 54.2% in the six-month survey (p < 0.001). Conclusion: A standardized interactive hand-off improves the efficiency and staff satisfaction, with a decreased rate of missed information at the cost of no additional time. View Full-Text
Keywords: patient hand-off; intensive care; children; anesthesia patient hand-off; intensive care; children; anesthesia
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MDPI and ACS Style

Dalal, P.G.; Cios, T.J.; DeMartini, T.K.M.; Prasad, A.A.; Whitley, M.C.; Clark, J.B.; Lin, L.; Mujsce, D.J.; Cilley, R.E. A Model for a Standardized and Sustainable Pediatric Anesthesia-Intensive Care Unit Hand-Off Process. Children 2020, 7, 123. https://doi.org/10.3390/children7090123

AMA Style

Dalal PG, Cios TJ, DeMartini TKM, Prasad AA, Whitley MC, Clark JB, Lin L, Mujsce DJ, Cilley RE. A Model for a Standardized and Sustainable Pediatric Anesthesia-Intensive Care Unit Hand-Off Process. Children. 2020; 7(9):123. https://doi.org/10.3390/children7090123

Chicago/Turabian Style

Dalal, Priti G., Theodore J. Cios, Theodore K.M. DeMartini, Amit A. Prasad, Meghan C. Whitley, Joseph B. Clark, Leon Lin, Dennis J. Mujsce, and Robert E. Cilley 2020. "A Model for a Standardized and Sustainable Pediatric Anesthesia-Intensive Care Unit Hand-Off Process" Children 7, no. 9: 123. https://doi.org/10.3390/children7090123

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