DEVELOPING AN OPERATING ROOM TO POSTANESTHESIA CARE UNIT HANDOFF CHECKLIST: A DELPHI STUDY

Ineffective communication and omitting clinical information can occur during patient care. A particularly vulnerable period for this breakdown is during the transfer of care (handoff) from the operating room (OR) to the post-anesthesia care unit (PACU). It can jeopardize patient safety, compromise work efficiency, and decrease patient and staff satisfaction. Despite mandates for a handoff process by The Joint Commission (TJC), the American Association of Nurse Anesthesiology (AANA), and the American Society of Anesthesiologists (ASA), there continues to be a lack of consensus on a standardized handoff tool. Checklists have proven effective in healthcare crises and the aviation industry, assisting decision-making. The aims of this project were to revise the OR to PACU Anesthesia Handoff Report Checklist (OPAHRC) for clinical implementation using the Delphi method at Kaiser Permanente West Los Angeles (KPWLA). We recruited an expert panel of Certified Registered Nurse Anesthetists (CRNAs) to participate in two Delphi rounds. We received 31 responses from participants throughout a three month period. In an iterative process, we analyzed feedback after each round and edited the checklist based on expert opinion and group consensus. Qualitative results included five common themes for essential elements during an anesthesia handoff, and 68% of respondents (N=21) described the checklist as "concise and thorough as is." Quantitative data results included a greater than 50% consensus in all 20 Likert-scale questions. This high level of group consensus from the surveys supported the suitability of the OPAHRC for implementation at KPWLA. This tool can potentially improve the handoff process and patient safety.