Anesthesia, Burnout, Professional, Surgery--Complications
Conditions
Keywords
major surgery, ansethesia care, postoperative complication, handover checklist, anesthesiologist burnout
Brief summary
Implementation of a standardized handover checklist for intraoperative anesthesia care transition attenuates burnout among anesthesiologists and improves postoperative outcomes of patients undergoing major surgery , both of which benefit the quality of patient care and the development of anesthesiology.
Detailed description
Many retrospective studies have demonstrated that among adults undergoing major surgery, complete handover of intraoperative anesthesia care compared with no handover was associated with a higher risk of adverse postoperative outcomes. Anesthesiologists keeping on working without handovers may experience symptoms of burnout which do not only pose a threat to the mental and physical health of the anesthesiologist, but also result in sub-optimal safety care of patients. Poor-quality handover without standardized processes can lead to diagnostic and therapeutic delays and precipitate adverse events. An improved system of anesthesia standardized handovers using a checklist would improve transfer of information and professional responsibility and therefore lead to the improvement of patient safety as well as burnout among anesthesiologists. Thus it is urgent to develop a standardized handover checklist for intraoperative anesthesia care to improve postoperative outcome of patients.
Interventions
DEVICEstandardized handover checklist
Following a review of relevant literatures and guidelines, a checklist consisting of the various key items necessary for giving continuing and safe intraoperative patient care was designed and validated by anesthesia residents and staff. Following 2-week to 1-month baseline data collection, each anesthesiologists and anesthesia residents in participating hospitals were asked to implement the safe-anesthesia checklist to improve practice over another 2-week to 1-month period. The checklist consists of an oral confirmation and closed-loop communication between the primary anesthesiologist and the replacement anesthesiologist. Evaluation of the effect of implementation of a standardized checklist during anesthesia care handover on patient safety during follow-up.
Sponsors
Zhejiang Provincial Tongde Hospital
First Affiliated Hospital of Zhejiang University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients aged 18 years and older undergoing major surgeries requiring a hospital stay of at least 1 night are enrolled in this study.
Exclusion criteria
* Adult patients aged less than 18 years undergoing major surgeries and were not requiring a hospital stay of at least 1 night are excluded.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of a composite of all-cause death, hospital readmission, or major postoperative complications | 30 days | The primary outcome that will be measured is a composite of all-cause death, hospital readmission, or major postoperative complications, all within 30 days post surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of major complications | 30 days | Postoperative major complications, defined by International Classification of Diseases, Tenth Revision (ICD-10) diagnostic codes |
| Incidence of ICU admission post surgery | 30 days | Incidence of postoperative intensive care unit (ICU) admission, ,within 30 days post surgery |
| The time of hospital length of stay (LOS) | up to 30 days | Hospital length of stay (LOS) |
| Incidence of 7 day-, 30 day-, 90 day- and inhospital mortality | 7/30/90 day | 7/30/90-day mortality, inhospital mortality |
| Any medical cost during hospital stay | up to 90 days | Any medical cost during hospital stay |
| Ventilation time within postoperative 30 days | Up to 30 days | Ventilation time within postoperative 30 days |
| Anaesthetic resuscitation time | Up to 24 hours | Anaesthetic resuscitation time after the surgery is completed |
| Incidence of emergency department (ED) visits | 90 days | Emergency department (ED) visits within 90 days of the index surgery |
Contacts
Primary ContactYe Hui
Backup ContactCheng Baoli
Outcome results
None listed