Introduction: Operating room (OR) staff changes can potentiate communication failures, potentially leading to adverse events and disruption of OR flow. OR handoffs are not universally standardized, though standardized sign outs have been proven to provide effective communication in other aspects of healthcare. We hypothesize creating a standardized handoff, with persistent auditing, will result in highly reliable, standardized communication between OR staff members. Methods: An engaged frontline stakeholder approached our OR quality improvement (QI) team, led by a QI experienced urology faculty member, with concern regarding lack of information discussed during surgical technician handoffs during staff changes. Following, the Surgical Intraoperative Handoff Initiative commenced from 5/2022 through 9/2022. The OR QI team created an audit tool for preliminary data collection, and current handoffs were audited. The pilot cohort of audits was discussed with stakeholders, including intraoperative staff and OR leadership, to develop a standardized communication protocol. A finalized communication tool was created with domains regarding sponges, sharps, hidden items, replaced items, instruments, implants, medications, procedure overview, and specimens. As a memory aid, an acronym of these domains, SHRIMPS, was affixed to each OR wall. Results: 23 cases were observed both pre- and post-implementation. Handoffs occurred in 83% of cases pre-intervention, of which only 42% included communication with the surgeon, and the elements of the handoff varied. Sharps were discussed in 78%, instrument needs in 61%, medications in 65%, specimens requiring collection in 39%, and hidden items in 30% of handoff communications. In the initial Plan-Do-Study-Act (PDSA) cycle, piloted and audited in urology, general surgery, and neurosurgery after implementation of the standardized handoff, 100% of the 15 observed cases had a handoff performed, averaging 65 seconds per handoff. Additionally, 100% of cases announced a handoff to the surgeon, and all elements were addressed 99.6% of the time. PDSA cycle 2 involved implementation to all service lines, and of the 9 cases observed, 100% had a handoff performed at an average of 86 seconds per handoff, with 100% of elements addressed. Conclusions: Little standardization of communication exists within the OR, especially regarding intraoperative staff changes. Implementation of a standardized handoff resulted in substantial improvement in critical communication during staff changes. SOURCE OF Funding: None
