Lack of Association Between Intraoperative Handoff of Care and Postoperative Complications

A Retrospective Observational Study

Vikas N. O'Reilly-Shah; Victoria G. Melanson; Cinnamon L. Sullivan; Craig S. Jabaley; Grant C. Lynde


BMC Anesthesiol. 2019;19(182) 

In This Article


Transitions of intraoperative anesthetic care are common, and controversy is likely to persist regarding their impact on clinical outcomes of interest. The balance between their potential to either introduce or mitigate harm may be heavily influenced by numerous elements of local practice that are difficult to quantify. Prior investigations suggest that intraoperative handoffs are associated with a sequential, nonzero risk for unintentional harm. However, the magnitude of these effect estimates has been variable. We posit that one significant source of variability in the literature is the accounting for confounders. Our investigation builds on prior work by examining the local impact of handoffs within the context of our care team model, conduct of care transitions, and approach to perioperative care. Additional work is needed to delineate how practice patterns or other factors, such as the use of structured communication tools, influence the impact of intraoperative anesthetic handoffs on postoperative outcomes.