Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2021 May;12(3):647-654.
doi: 10.1055/s-0041-1731714. Epub 2021 Jul 28.

A Collaborative Partnership between the Multicenter Handoff Collaborative and an Electronic Health Record Vendor

Bommy Hong Mershon  1 , Andrea Vannucci  2 , Trent Bryson  3 , Felix Lin  4 , Philip E Greilich  3 , Guy Dear  5 , Patrick Guffey  6 , Aalok Agarwala  7
Affiliations
Multicenter Study

A Collaborative Partnership between the Multicenter Handoff Collaborative and an Electronic Health Record Vendor

Bommy Hong Mershon et al. Appl Clin Inform. 2021 May.

Abstract

Objectives: The operating room is a specialized, complex environment with many factors that can impede effective communication during transitions of care between anesthesia clinicians. We postulated that an efficient, accessible, standardized tool for intraoperative handoffs built into standard workflow would improve communication and handoff safety. Most institutions now use an electronic health record (EHR) system for patient care and have independently designed intraoperative handoff tools, but these home-grown tools are not scalable to other organizations and lack vendor-supported features. The goal of this project was to create a standardized, intraoperative handoff tool supported by EHR functionality.

Methods: The Multicenter Handoff Collaborative, with support from the Anesthesia Patient Safety Foundation, created a working group of frontline anesthesia experts to collaborate with a development team from the EHR vendor (Epic Systems) to design a standardized intraoperative handoff tool. Over 2 years, the working group identified the critical elements for the tool and software usability, and the EHR team designed a standardized intraoperative handoff tool that is accessible to any institution using this EHR.

Results: The first iteration of the intraoperative handoff tool was released in August 2019, with a second version in February 2020. The tool is standardized but customizable by individual institutions.

Conclusion: We demonstrate that work on complex health care processes critical to patient safety, such as handoffs, can be performed on a national scale through cross-industry collaboration. Frontline experts can partner with health care industry vendors to design, build, and release a product on an accelerated timeline.

PubMed Disclaimer

Conflict of interest statement

Author F.L.'s work documented in this manuscript was performed as part of his employment at Epic Systems. All other authors report no conflict of interest.

Figures

Fig. 1
Fig. 1
Timeline of MHC formation, EHR workgroup, and Epic Systems partnership from development and dissemination of the intraoperative handoff tool in the EHR system. EHR, electronic health record; MHC, Multicenter Handoff Collaborative.
Fig. 2
Fig. 2
First version of the intraoperative handoff tool (reprinted with permission from ©2020 Epic Systems Corporation) in the Epic intraoperative record. Limitations related to programming in Epic prevented the complete inclusion of all elements that the group had requested during initial planning.
Fig. 3
Fig. 3
Current updated version of the intraoperative handoff tool (reprinted with permission from ©2020 Epic Systems Corporation) in the Epic intraoperative record. It includes more critical information elements that our group agreed were necessary. In the live intraoperative record, this sidebar is shown as a continuous vertical column that can be viewed by scrolling up and down. The goal is to limit to one scroll to view the entire tool. When an anesthesia provider clicks the Handoff Complete button at the end, the staffing grid will automatically open to allow the provider to be able to sign over to the next provider at the time of the handoff. It also inserts the handoff icon into the intraoperative record to mark the time of the handoff.
See this image and copyright information in PMC

References

    1. Washington, DC: National Academies Press; 2001. Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. - PubMed
    1. Joint Commission Center for Transforming Healthcare releases targeted solutions tool for hand-off communications. Jt Comm Perspect. 2012;32(08):1. - PubMed
    1. Jurevvicz K, Alfred M, Neyens D M, Catchpole K, Joseph A, Reeves S T. Investigating intraoperative and intraprofessional handoffs in anesthesia. Proc Hum Factors Ergon Soc Annu Meet. 2018;62(01):469–473.
    1. Cooper J B, Newbower R S, Long C D, McPeek B. Preventable anesthesia mishaps: a study of human factors. Anesthesiology. 1978;49(06):399–406. - PubMed
    1. Scoville R, Little K. Cambridge, MA: Institute for Healthcare Improvement; 2014. Comparing Lean and Quality Improvement. IHI White Paper.

Publication types