Faculty, Staff and Student Publications

Language

English

Publication Date

11-4-2025

Journal

BMJ Open

DOI

10.1136/bmjopen-2025-110401

PMID

41248419

PMCID

PMC12587940

PubMedCentral® Posted Date

11-4-2025

Abstract

Introduction: Intraoperative anaesthesia handoffs represent a risk point in the care of surgical patients. Although often necessary to prevent fatigue, improve vigilance and optimise operational efficiency, critical information can be lost, potentially leading to postoperative complications. Structured handoffs can increase the transfer of knowledge during intraoperative anaesthesia handoffs, improving their quality. We therefore propose to test the primary hypothesis that a semi-structured intraoperative anaesthesia handoff cognitive aid reduces the number of serious 30-day complications in surgical patients.

Methods and analysis: We will enrol adults having non-cardiac surgery who are scheduled to have an intraoperative anaesthesia handoff for operational reasons. We plan a cluster randomised trial (enrolling over 18 months, anticipated sample size approximately 4500 patients) that will compare the Epic Electronic Health Record intraoperative anaesthesia handoff cognitive aid to routine handoffs. Our primary outcome will be the number of serious postoperative complications within 30 days. Our secondary outcomes will be: (1) the number of minor complications; and (2) the duration of postoperative hospitalisation. Bayesian analysis with generalised linear multilevel modelling will be used to estimate the effect of structured handoffs on the primary and secondary outcomes.

Ethics and dissemination: This study has been approved by the local institutional review board with a waiver of informed consent. Results will be disseminated in the medical literature with de-identified data available on request.

Keywords

Humans, Patient Handoff, Postoperative Complications, Randomized Controlled Trials as Topic, Anesthesia, Bayes Theorem, Cognition, Electronic Health Records, ANAESTHETICS, Safety, Quality in health care, Randomized Controlled Trial

Comments

Trial registration number: NCT06533111.

Published Open-Access

yes

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