Using Six Sigma Methodology to Improve Handoff Communication in High-Risk Patients

Background: During the analyses of adverse events, a commonly described risk factor is the sharing of patient information. Objective: The objective for this project was to better understand and improve the postoperative handoff process for children with heart disease. Methods: The existing handoff process was evaluated and improved using Six Sigma methodology and medical simulation training. Time-based metrics were compared before and after implementing performance improvement initiatives. Results: 29 preand 142 post-intervention handoff events were studied. Initiatives resulted in a reduced handoff turnaround time (15.3 min to 9.6 min; P <0.001) and time to obtaining critical laboratory studies (13.0 min to 2.4 min; P <0.001); an increase in chest radiographs completed (60 percent vs. 94 percent; P <0.01) and percent of patients placed on cardio-respiratory monitoring (86 percent vs. 99 percent; P <0.01) within unit standards. Conclusion: In children undergoing surgical intervention, performance improvement principles can improve the handoff process and decrease the delay of time-sensitive therapies.