Christian James Turner is an intensivist and clinical instructor, University Hospital of Northern British Columbia and University of British Columbia, Canada. Barbara Haas is an assistant professor, Interdepartmental Division of Critical Care Medicine and Division of General Surgery, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada. Christie Lee, Michael Eric Detsky, and Laveena Munshi are assistant professors, Interdepartmental Division of Critical Care Medicine, Sinai Health System, University of Toronto. Savtaj Brar is an assistant professor, Department of Surgery, Sinai Health System, University of Toronto.
Am J Crit Care. 2018 Sep;27(5):392-397. doi: 10.4037/ajcc2018114.
Structured communication tools for postoperative surgical handover to the intensive care unit (ICU) have shown promise, yet little work has addressed ongoing daily communication between the surgery and ICU teams thereafter.
Evaluation of a novel, 2-part communication intervention between surgery and ICU teams focused on postoperative handover and ongoing daily communication.
A mixed-methods, pre- and postintervention survey study was conducted in a closed quaternary medical-surgical ICU. Study participants (N = 112) included ICU physicians, nurses, allied health professionals, and physicians on the surgical team. The intervention consisted of a handover checklist completed postoperatively on arrival in the ICU and a 5-item communication tool completed daily by the surgical team.
Satisfaction improved significantly in the following areas: postoperative handover communication ( < .001), daily communication ( = .001), understanding the postoperative plan ( < .001), initiation of deep vein thrombosis prophylaxis ( = .008), initiation of feeding ( = .009), and daily primary resident contact ( = .008). No significant improvement was seen in communication regarding disposition or overall improvement in patient safety risk from communication errors.
A simple handover checklist improved health care practitioner satisfaction with communication during postoperative handover to the ICU. Concise daily communication tools are an appropriate option for improving ongoing communication between surgeons and the ICU team thereafter.
针对术后向重症监护病房（ICU）交接的结构化沟通工具已初见成效，但对于此后手术团队与 ICU 团队之间的日常持续沟通，相关工作仍较少涉及。
评估一种新的、由两部分组成的针对术后交接和日常持续沟通的手术团队与 ICU 团队间沟通干预措施。
采用前瞻性和回顾性调查研究，在一家封闭的四级综合外科 ICU 中进行。研究参与者（N=112）包括 ICU 医生、护士、联合保健专业人员以及外科医生。干预措施包括术后到达 ICU 时完成的交接清单和外科团队每天完成的 5 项沟通工具。
以下方面的满意度显著提高：术后交接沟通（<0.001）、日常沟通（=0.001）、理解术后计划（<0.001）、深静脉血栓预防的启动（=0.008）、喂养的启动（=0.009）和每日主治住院医师联系（=0.008）。在有关患者去向或因沟通错误导致的患者安全风险整体改善方面，沟通没有显著改善。
简单的交接清单提高了医疗保健从业者对术后向 ICU 交接期间沟通的满意度。简洁的日常沟通工具是改善此后外科医生与 ICU 团队之间持续沟通的合适选择。
