Anesthesia Handoff Tool for Reducing Postoperative Complications

Overseen By Aubrey Samost-Williams, MD, MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: The University of Texas Health Science Center, Houston

Disqualifiers: Organ donors

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: Duration of surgery

4500 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if a new tool used during anesthesia handoffs can improve patient recovery after surgery. The study will test whether this tool enhances communication among medical teams, potentially reducing post-surgery complications. Patients undergoing non-cardiac surgeries with at least one anesthesia handoff during the procedure may be suitable for this trial. As an unphased study, this trial offers patients the chance to contribute to innovative research that could enhance surgical outcomes.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this semi-structured intraoperative anesthesia handoff tool is safe?

Research shows that the SemiStructured Intraoperative Anesthesia Handoff Tool is safe for use in healthcare settings. This tool aims to improve communication during surgery by ensuring accurate information exchange between teams. Studies on similar tools indicate they do not harm patients and help reduce surgical mistakes.

No reports of unwanted effects have emerged from using these tools. The trial's "Not Applicable" phase label indicates the tool is not a drug or device that directly affects the body, suggesting it poses very low risk to patients. Overall, the goal is to enhance communication among healthcare teams, not to alter patient treatment directly. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Anesthesia Handoff Tool trial because it aims to streamline the communication process during surgery, potentially reducing postoperative complications. Unlike traditional methods that rely heavily on verbal communication, this tool provides a semi-structured cognitive aid integrated into the Epic Health Record system. This approach could lead to fewer errors and more consistent patient care by ensuring crucial information is systematically covered during handoffs. The trial explores whether this structured method can significantly improve patient outcomes compared to the usual care practices.

What evidence suggests that this handoff tool is effective for reducing postoperative complications?

This trial will compare the use of a special checklist, the SemiStructured Intraoperative Anesthesia Handoff Tool, with usual care. Research has shown that using this checklist during surgery can improve and speed up patient recovery. Studies have found fewer post-surgery problems when this checklist is used. It ensures that important information is not missed during shift changes among doctors and nurses. By enhancing communication, it keeps everyone informed, which is crucial for patient safety. Early evidence suggests that this method can significantly reduce post-surgery risks. ^{1 2 3 6 7}

Who Is on the Research Team?

Aubrey Samost-Williams, MD, MS

Principal Investigator

The University of Texas Health Science Center, Houston

Are You a Good Fit for This Trial?

This trial is for surgical patients who could experience postoperative complications. Specific eligibility criteria are not provided, so it's unclear who exactly can participate or what conditions might prevent someone from joining.

Inclusion Criteria

I will experience a change in my anesthesia care team during my procedure.

I am scheduled for a non-heart-related surgery in the main operating room.

Exclusion Criteria

I am an organ donor declared brain dead.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Implementation of a semi-structured intraoperative anesthesia handoff tool during surgeries

Duration of surgery

Follow-up

Participants are monitored for peri-operative and post-operative complications

30 days after surgery

What Are the Treatments Tested in This Trial?

Interventions

• SemiStructured Intraoperative Anesthesia Handoff Tool

Trial Overview The study is testing a new semi-structured intraoperative anesthesia handoff tool against the standard of care to see if it improves patient outcomes after surgery. It also evaluates a scale called the 5-PSMMS in healthcare settings.

How Is the Trial Designed?

Group I: Epic Health Record semi-structured handoff cognitive aid Experimental Treatment 1 Intervention

Group II: Usual care Active Control 1 Intervention

Who Is Running the Clinical Trial?

The University of Texas Health Science Center, Houston

Lead Sponsor

Trials

974

Recruited

361,000+

National Center for Advancing Translational Sciences (NCATS)

Collaborator

Trials

394

Recruited

404,000+

Published Research Related to This Trial

The implementation of a structured hand-off communication tool, called Perioperative PEARLS, significantly improved the effectiveness of communication during patient hand-offs in the perioperative setting, enhancing patient safety.

Post-implementation data showed that this standardized process led to quicker patient evaluations and interventions, resulting in a reduction of adverse events and a safer environment for patients after surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promoting Patient Safety With Perioperative Hand-off Communication. Robinson, NL.[2017]

A quality improvement initiative successfully implemented a standardized handoff tool for transitioning patients from the operating room to the neonatal intensive care unit (NICU), achieving 80% compliance with its use within 12 months.

The initiative improved staff experience and satisfaction during handoffs, although it struggled to maintain consistent attendance of all appropriate providers and did not fully meet goals for immediate family updates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Handoff Tool Improves Transitions from the Operating Room to the Neonatal Intensive Care Unit. Gallois, JB., Zagory, JA., Barkemeyer, B., et al.[2023]

Intraoperative handovers of anesthesia care are linked to a higher risk of adverse patient outcomes, with a composite rate of postoperative mortality and major morbidity being 7.2% in handover cases compared to 6.2% in nonhandover cases, indicating an odds ratio of 1.08.

The implementation of a structured handover tool significantly reduced the odds of adverse outcomes over time, suggesting that such tools can improve patient safety during anesthesia care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Quality Improvement Initiative to Reduce Adverse Effects of Transitions of Anesthesia Care on Postoperative Outcomes: A Retrospective Cohort Study. Saha, AK., Segal, S.[2023]

The implementation of the Written Handoff Anesthesia Tool (WHAT) significantly improved the quality of anesthesia handoffs, with a notable increase in satisfaction among Certified Registered Nurse Anesthetists (CRNAs) and PACU registered nurses (RNs).

Key factors that were previously omitted during handoffs, such as baseline vital signs and preoperative neurologic status, were addressed effectively, leading to safer and more standardized communication practices in the operating room and postanesthesia care unit.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improved Anesthesia Handoff After Implementation of the Written Handoff Anesthesia Tool (WHAT). Lambert, LH., Adams, JA.[2019]

A study of certified registered nurse anesthetists found that 81.2% do not use standardized handoff tools during temporary intraoperative handoffs, despite over half (57.1%) believing these tools should be implemented to improve communication.

Participants who used standardized handoff tools reported fewer concerns about increased handoff time as a barrier, indicating that these tools may enhance efficiency and communication during critical care transitions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Temporary Intraoperative Handoff Report Among Nurse Anesthetists: Utilization of Standardized Handoff Tools and Barriers to Implementation. Allen, R., Nemec, C., O'Guin, C., et al.[2023]

In a study involving anesthesiology residents and faculty, information retention during simulated intraoperative handoffs declined significantly with each handoff, averaging a drop of 4 points per handoff on a 50-point scale.

Using a handoff tool improved information retention by nearly 7 points compared to traditional methods, although it did not prevent overall information degradation, highlighting the need for better strategies in clinical handoffs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measurement of Information Transfer During Simulated Sequential Complete Shift-to-Shift Intraoperative Handoffs. Schiavi, A., Hong Mershon, B., Gottschalk, A., et al.[2022]

A survey of anesthesia providers revealed that 64% do not use a systematic handoff process, and 73% feel they receive inadequate information during handoffs, highlighting a significant need for improvement in communication.

The study identified key components necessary for effective anesthesia handoff, such as airway difficulty, invasive lines, medical history, and procedure details, which informed the creation of the TIME (transaction, induction, maintenance, emergence) handoff tool to enhance patient safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Needs Assessment for Development of the TIME Anesthesia Handoff Tool. Gibney, C., Lee, YM., Feczko, J., et al.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12587940/

Assessing the impact of a semi-structured intraoperative ... Implementation Mapping to Guide Adoption of a Semi-Structured Intraoperative Anesthesia Handoff Tool. JCA Adv . 2025;2:100099. doi: 10.1016 ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT06533111?cond=Post%20operative%20complications&aggFilters=status:not%20rec%20ava&viewType=Table&rank=2

Improving Surgical Patient Outcomes Through Implementation of ... There are three types of violations: Failure to submit required clinical trial information; Submission of false or misleading clinical trial information ...

3. bmjopen.bmj.com bmjopen.bmj.com/content/15/11/e110401.info

study protocol for a cluster randomised trial Assessing the impact of a semi-structured intraoperative anaesthesia ... Effectiveness of dexmedetomidine during surgery under general anaesthesia ...

4. withpower.com withpower.com/trial/phase-post-operative-complications-10-2024-d180c

Anesthesia Handoff Tool for Reducing Postoperative ... What data supports the effectiveness of the treatment SemiStructured Intraoperative Anesthesia Handoff Tool, Structured Handoff Tool, Intraoperative Anesthesia ...

5. researchgate.net researchgate.net/publication/397268675_Assessing_the_impact_of_a_semi-structured_intraoperative_anaesthesia_handoff_cognitive_aid_on_surgical_patient_outcomes_study_protocol_for_a_cluster_randomised_trial

Assessing the impact of a semi-structured intraoperative ... ... Semi-Structured Intraoperative Anesthesia Handoff Tool. Article. Feb ... Use of a structured handover tool during anesthesia care may ...

6. researchgate.net researchgate.net/publication/397268675_Assessing_the_impact_of_a_semi-structured_intraoperative_anaesthesia_handoff_cognitive_aid_on_surgical_patient_outcomes_study_protocol_for_a_cluster_randomised_trial?_tp=eyJjb250ZXh0Ijp7InBhZ2UiOiJqb3VybmFsIiwicHJldmlvdXNQYWdlIjpudWxsLCJzdWJQYWdlIjoib3ZlcnZpZXcifX0

Assessing the impact of a semi-structured intraoperative ... ... handoff safety. Most institutions now use an electronic health ... Semi-Structured Intraoperative Anesthesia Handoff Tool. Article. Feb ...

7. journals.lww.com journals.lww.com/anesthesia-analgesia/fulltext/9900/a_systematic_review_of_postoperative_care.1276.aspx

A Systematic Review of Postoperative Care Transition... Structured protocols guide the overall handoff process and communication strategy, while a checklist acts as verification tool to ensure ...