Abstract：
OBJECTIVE: We evaluated the effectiveness and implementability of a standardized EHR-integrated handoff report to support intraoperative handoffs.
METHODS: A pre-post intervention study was used to compare the quality of intraoperative handoffs supported by unstructured notes (pre) to structured, standardized EHR-integrated handoff reports (post). Participants included anesthesia clinicians involved in intraoperative handoffs. A mixed-method approach was followed, supported by general observations, shadowing, surveys, and interviews.
RESULTS: One hundred and fifty-one intraoperative permanent handoffs (78 pre, 73 post) were included. One hundred percent of participants in the post-intervention cohort utilized the report. Compared to unstructured, structured handoffs using the EHR-integrated handoff report led to: (1) significant increase in the transfer of information about airway management (55%-78%, P < .001), intraoperative course (63%-86%, P < .001), and potential concerns (64%-88%, P < .001); (2) significant improvement in clinician satisfaction scores, with regards to information clarity and succinctness (4.5-4.7, P = .002), information transfer (3.8-4.2, P = .011), and opportunities for fewer errors reported by senders (3.3-2.5, P < .001) and receivers (3.2-2.4, P < .001); and (3) significant decrease in handoff duration (326.2-262.3 s, P = .016). Clinicians found the report implementation highly acceptable, appropriate, and feasible but noted a few areas for improvement to enhance its usability and integration within the intraoperative workflow.
CONCLUSIONS: A standardized EHR-integrated handoff report ensures the effectiveness and efficiency of intraoperative handoffs with its structured, consistent format that-promotes up-to-date and pertinent intraoperative information transfer; reduces opportunities for errors; and streamlines verbal communication. Handoff standardization can promote safe and high-quality intraoperative care.
METHODS: A pre-post intervention study was used to compare the quality of intraoperative handoffs supported by unstructured notes (pre) to structured, standardized EHR-integrated handoff reports (post). Participants included anesthesia clinicians involved in intraoperative handoffs. A mixed-method approach was followed, supported by general observations, shadowing, surveys, and interviews.
RESULTS: One hundred and fifty-one intraoperative permanent handoffs (78 pre, 73 post) were included. One hundred percent of participants in the post-intervention cohort utilized the report. Compared to unstructured, structured handoffs using the EHR-integrated handoff report led to: (1) significant increase in the transfer of information about airway management (55%-78%, P < .001), intraoperative course (63%-86%, P < .001), and potential concerns (64%-88%, P < .001); (2) significant improvement in clinician satisfaction scores, with regards to information clarity and succinctness (4.5-4.7, P = .002), information transfer (3.8-4.2, P = .011), and opportunities for fewer errors reported by senders (3.3-2.5, P < .001) and receivers (3.2-2.4, P < .001); and (3) significant decrease in handoff duration (326.2-262.3 s, P = .016). Clinicians found the report implementation highly acceptable, appropriate, and feasible but noted a few areas for improvement to enhance its usability and integration within the intraoperative workflow.
CONCLUSIONS: A standardized EHR-integrated handoff report ensures the effectiveness and efficiency of intraoperative handoffs with its structured, consistent format that-promotes up-to-date and pertinent intraoperative information transfer; reduces opportunities for errors; and streamlines verbal communication. Handoff standardization can promote safe and high-quality intraoperative care.
摘要：
目的：我们评估了支持术中切换的标准化EHR整合切换报告的有效性和可实施性。
方法：一项干预前研究用于比较非结构化注释（预）到结构化，标准化的EHR集成切换报告(后)。参与者包括参与术中交接的麻醉临床医生。采用混合方法，在一般意见的支持下，阴影，调查,和采访。
结果：一百五十一次术中永久性移交（78个前，73个职位）被包括在内。干预后队列中百分之百的参与者使用了该报告。与非结构化相比，使用EHR集成切换报告的结构化切换导致：（1）有关气道管理的信息传输显着增加（55％-78％，P<.001),术中过程（63%-86%，P<.001),和潜在的担忧(64%-88%，P<.001）；（2）临床医生满意度评分显着提高，关于信息的清晰度和简洁性(4.5-4.7，P=0.002)，信息传递（3.8-4.2，P=.011），以及发送方（3.3-2.5，P<.001）和接收方（3.2-2.4，P<.001）报告的错误较少；（3）切换持续时间显着减少（326.2-262.3s，P=.016）。临床医生发现该报告的实施非常可接受，适当，并且可行，但指出了一些需要改进的地方，以增强其可用性和在术中工作流程中的整合。
结论：标准化的EHR集成切换报告确保了术中切换的有效性和效率，一致的格式-促进最新和相关的术中信息传递;减少错误的机会;并简化口头交流。交接标准化可以促进安全和高质量的术中护理。
方法：一项干预前研究用于比较非结构化注释（预）到结构化，标准化的EHR集成切换报告(后)。参与者包括参与术中交接的麻醉临床医生。采用混合方法，在一般意见的支持下，阴影，调查,和采访。
结果：一百五十一次术中永久性移交（78个前，73个职位）被包括在内。干预后队列中百分之百的参与者使用了该报告。与非结构化相比，使用EHR集成切换报告的结构化切换导致：（1）有关气道管理的信息传输显着增加（55％-78％，P<.001),术中过程（63%-86%，P<.001),和潜在的担忧(64%-88%，P<.001）；（2）临床医生满意度评分显着提高，关于信息的清晰度和简洁性(4.5-4.7，P=0.002)，信息传递（3.8-4.2，P=.011），以及发送方（3.3-2.5，P<.001）和接收方（3.2-2.4，P<.001）报告的错误较少；（3）切换持续时间显着减少（326.2-262.3s，P=.016）。临床医生发现该报告的实施非常可接受，适当，并且可行，但指出了一些需要改进的地方，以增强其可用性和在术中工作流程中的整合。
结论：标准化的EHR集成切换报告确保了术中切换的有效性和效率，一致的格式-促进最新和相关的术中信息传递;减少错误的机会;并简化口头交流。交接标准化可以促进安全和高质量的术中护理。
