DNP Scholarly Projects

Implementing a Multidisciplinary Bedside Handoff to Improve Communication and Reduce Errors in Surgical Transfers

Abstract

BACKGROUND: Breakdowns in communication amongst team members leads to poor patient outcomes (Massa et al., 2021). Commonly cited barriers to communication include lack of standardization and time pressure (Abraham et al., 2023). Multidisciplinary handoffs are a strategy to overcoming barriers, improving team communication and promoting patient safety by 40% (Njambi et al., 2021).

METHODS: This quality improvement project utilized a mixed-methods convergent design using quantitative mid- and post-implementation surveys including qualitative descriptive method. Participants included 53 clinicians across a surgical services department including a hospital operating room, preoperative holding area, and post anesthesia care unit (PACU). An adapted version of the Iowa Implementation for Sustainability Framework was used throughout intervention implementation.

INTERVENTION: The multidisciplinary handoff bundle included a revised door-to-door workflow, and updated handoff communication tool (Rainbow Sheet), implementation of multidisciplinary bedside handoff, and staff education with cue cards to reinforce best practices. Outcomes and insights were collected through mid- and post-implementation surveys.

RESULTS: A 91.75% Rainbow Sheet completion rate was achieved, demonstrating consistent bedside handoff documentation. Staff were satisfied overall with the multidisciplinary handoff, they perceived that the bedside handoff improved communication, and they perceived that bedside handoff improved patient safety.

CONCLUSION: Implementing a bedside handoff that includes the multidisciplinary team strengthens communication amongst the team, changes the way safe transfers of care are viewed by the participating team and aligns evidence with practice regarding patient safety.

Keywords: multidisciplinary team, operating room, perioperative, workflow change, communication improvement, error reduction, patient safety

References

Massa, S., Wu, J., Wang, C., Peifer, H., & Lane-Fall, M. B. (2021). Interprofessional training and communication practices among clinicians in the postoperative ICU handoff. The Joint Commission Journal on Quality and Patient Safety, 47(4), 242–249. https://doi.org/10.1016/j.jcjq.2020.12.004

Njambi, M., Rawson, H., & Redley, B. (2021). A brief intervention to standardize postanesthetic clinical handoff. Nursing & Health Sciences, 23(1), 219–226. https://doi.org/10.1111/nhs.12803

Abraham J., Duffy C., Kandasamy M., France D., Greilich P. (2023). An evidence synthesis on perioperative handoffs: A call for balanced sociotechnical solutions. International journal of medical informatics. https://pubmed.ncbi.nlm.nih.gov/36948060/

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Date

11-24-2025

First Advisor

Kaylyn Bourne, DNP, APRN, FNP-C

Second Advisor

David Phillippi, PhD

Department

Nursing, School of

College

Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project

Degree

Doctorate of Nursing Practice (DNP)

Degree Level

Doctoral

Degree Grantor

Belmont University

Keywords

multidisciplinary team; operating room; perioperative; workflow change; communication improvement; error reduction; patient safety

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