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Effect of a Structured Checklist on Quality of Intraoperative Change-of-shift Handoffs: A pre-post control study


 Objective: Handoff without a structured format is prone to the omission of information and could be a potential risk to patient safety. We sought to determine the effect of a structured checklist on the quality of intraoperative change of shift handoff between scrubs and circulating.Methods: We conducted a pre-post control intervention study on operating room wards of two teaching hospitals from February to November 2020. This research was conducted in three stages as follows: assessing the current situation (as a group before the intervention), performing the intervention and evaluating the effect of using a checklist on handoff quality after the intervention in two groups: with and without checklist. We examined the quality of handoff between scrub and circular personnel in terms of handoff duration and quality, omission of information as well as changes in personnel satisfaction. Data were analyzed using SPSS software version 26.Results: A total of 120 handoffs were observed and evaluated. After intervention in the group using the checklist, the percentage of information omission in surgical report was decreased from 19.5 to 12.1% between scrubs (P<0.00) and from 16.8 to 14.1% between circulating (P <0.03). Also, in the role of scrub, the mean overall score of handoff process quality was significantly higher after the intervention (x̄=7±1.5) than before it (x̄=6.5±0.9) (p<0.02). In the role of circulating, despite the positive effect of overall score checklist, no significant difference was observed (p<0.08). The use of checklist significantly increased the handoff duration between scrubs (p<0.03) and circulating (p<0.00).Conclusion: Structured checklist has a positive impact on improving the quality of communication between the surgical team, reducing the information omission rate and increasing the satisfaction.