According to a study published in JAMA (January 9, 2018), there is an association between complete handover of anesthesia care of a patient from one anesthesiologist to another and adverse postoperative outcomes among patients undergoing major surgery. Specifically, adverse outcomes impacted 44% of the complete handover group compared with just 29% of the no handover group. This finding of “significantly higher risk” was based on a “composite of all-cause death, hospital readmission or major postoperative complications over 30 days.”
In an editorial that accompanied the study, JAMA says the study defined a complete handover as “one in which the initial anesthesiologist handed over care of a patient to another anesthesiologist but then was no longer available.” The study showed that these complete handovers may be on the rise. In evaluating data from 313,066 patients, researchers identified 5,941 (1.9%) who underwent surgery with complete handover of anesthesia care. They report that the “percentage of patients undergoing surgery with a handover of anesthesiology care progressively increased each year of the study, reaching 2.9% in 2015.”
Since the study did not determine if other underlying factors contributed to the adverse outcomes or address the level of communication that occurred during the handovers, the JAMA editorial does not support elimination or reduction of complete handovers. Instead, it makes a case for improving these handovers through better communication among clinicians.
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