Development, Implementation, and Evaluation of a Standardized Hand–Off Communication Tool at Children's Hospital of Michigan


Poorly communicated information during postoperative patient hand-offs can result in medical errors that compromise patient safety. Applying a standardized communication hand-off tool encourages consistency and accuracy during transfer of patient information, subsequently reducing communication failures that are associated with preventable medical errors. The aim of this evidence-based quality improvement project was to design and apply a standardized hand–off tool for use between Certified Registered Nurse Anesthetists (CRNAs) CRNAs, Pediatric Anesthesia Fellows, Anesthesiologists, and Pediatric Intensive Care Unit (PICU) Fellows and RNs at Children’s Hospital of Michigan. The tool was developed in collaboration with an interprofessional team and incorporated input obtained from a pre-intervention survey that the stakeholders identified as critical to communicate during transfer of care for their patient population. The communication tool was piloted for one month following which a postintervention survey was administered to assess the perceptions of the CRNAs, Pediatric Anesthesia Fellows, Anesthesiologists, and PICU Fellows and RNs regarding the tool’s use and functionality. The tool was modified according to this input and is under consideration for permanent adoption by Children’s Hospital of Michigan.



Communication, Transfer of care, Certified registered nurse anesthetist, Standardized hand-offs, Pediatrics, Anesthesia