Anesthesia Experts, Epic Partner on Handoff Tool
A group of anesthesia experts worked with Epic Systems to design a standardized intraoperative handoff tool to improve communication during transitions of care between anesthesia clinicians, according to an article in the Journal of Applied Clinical Informatics.
The Multi-Center Handoff Collaborative (MHC) was formed in October 2015 at a meeting of the American Society of Anesthesiology (ASA). The MHC is designed as an organizational structure to support the advancement of safe and reliable patient handoffs. With support from the Anesthesia Patient Safety Foundation (APSF), it created a working group to work with Epic on the tool.
The first author on the paper describing the effort is Bommy Hong Mershon, M.D., of the Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine in Baltimore. Other group represented include Massachusetts General Hospital/Harvard University, University of Texas Southwestern - Dallas, University of Colorado/Children's Hospital Colorado, Duke University, University of Mississippi, and University of Rochester.
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 using Epic, the paper noted.
The paper describes how complications related to anesthesia have been associated with inadequate communication since at least 1978, and that the intraoperative period is particularly challenging for handoffs because experience and level of training often differ among anesthesia providers; the point in the procedure affects the type and amount of information that needs to be relayed; and real-time patient care issues can arise during handoffs that require attention and intervention by the anesthesia providers.
The paper said the MHC formed a partnership with Epic to accelerate development of EHR-based tools that could facilitate information transfer during perioperative handoffs. This cross-industry partnership accelerated the design and implementation of a durable, adaptable intraoperative handoff tool that was made widely available to all Epic Systems users.
“The handoff tool provides a structured approach, incorporates the prompting features of a checklist, and supports documentation of compliance as well as an intuitive and streamlined clinical workflow. However, to encourage individual institutional adoption, several elements were designed to be customizable,” the paper notes.
The authors note that although their group found success by bringing clinicians and EHR developers together with the guidance and support of APSF, “additional work will be needed if these types of innovative, cross-industry partnerships are to be generalizable. We believe clear delineation, dissemination, and alignment of patient safety priorities must be the central focus to each group's strategy.”
