Handover using ISBAR principles in two perioperative sites – a quality improvement project

Abstract

Background: ISBAR is a structured approach to communication between health care providers, particularly for the purpose of transferring patient clinical care. The ISBAR acronym refers to Identification, Situation, Background, Assessment and Request or Recommendation.

This paper provides the final report on a quality improvement project (QIP) that was carried out in the perioperative unit at two campuses of a large Melbourne metropolitan hospital. The final phase of this project addressed the concluding audits measuring compliance with ISBAR handover principles at selected handover episodes during the patient care journey through the perioperative suite. The previous two phases established baseline data for all handovers points that are examined in this project plus some initial periodic analysis of the subsequent audits of these perioperative handover points.

Method: This phase of the project was a planned extension of a multisite observational, pre- and post-intervention study. It involved audits of perioperative handovers at selected handover points over six months in 2017. It replicated the design of the previous phases of the project.

Results: The outcome of this phase of the QIP indicated that overall compliance with ISBAR handover principles at observed handover points improved over time. There were exceptions at particular points of the handover journey for specific sections of the audit tool at one site.

Implications for practice: Compliance with ISBAR handover principles has been observed to improve over time in the setting of ongoing audit and augmented education programs. Similar outcomes may be possible in a similar practice setting.