Standardized operating room handoffs significantly improve surgical communication and patient safety, study finds

A new study presents a successful quality improvement program that significantly improves surgical safety. By implementing a standardized handoff protocol, known as SHRIMPS, the study demonstrates how effective communication in operating rooms (ORs) can reduce the risk of errors and improve patient care.

The results are published in the Journal of the American College of Surgeonsin an article titled “Surgical Intraoperative Handoff Initiative: Standardizing Operating Room Communication Using SHRIMPS.”

“This study is a great example of how quality improvement initiatives can lead to better patient outcomes,” said study co-author Madeline Anderson, DO, a surgical resident at the University of Kentucky. “By standardizing communication during surgical procedures, we can ensure that all team members are informed and that critical information is communicated consistently, reducing the risk of errors.”

Prompted by a front-line stakeholder’s concerns about inadequate quality surgical technician transfers, the Quality Improvement (QI) team at the Lexington VA Medical Center, affiliated with University Hospital of Kentucky, developed an audit tool to evaluate transfers in various surgical cases from May 2022 to February 2024. Initial audits found that transfers occurred in 82.6% of cases, but only 34.4%. critical elements had been communicated.

In response, the team, in collaboration with operating room staff, developed a standardized communication checklist with the acronym “SHRIMP” (sharps, sponges, objects hidden or retained, items replaced, instruments and implants, medications, procedure overview, specimens).

Although it has nothing to do with the crustacean, the team chose the acronym SHRIMPS as a useful mnemonic for surgical teams. This checklist was prominently displayed in all operating rooms at the Lexington VA Medical Center.

Main findings

• Prior to the implementation of SHRIMPS, transfers occurred in 82.6% of cases, with only 34.4% of critical items communicated.
• After implementing SHRIMPS, 100% of cases included transfers, with 98.2% of critical items addressed.
• Transfer times averaged 69.4 seconds after implementation, ensuring thorough communication without significantly increasing transfer time.
• Announcements of transfers to the entire OR team increased to 97.1%, ensuring all staff were aware of staff changes.

“Part of the success of SHRIMPS comes from the QI team engaging with front-line and first-line responders in the operating room, including surgical technicians and circulating nurses,” said Dr. Anderson . “This approach ensures that the tool is more effective and creates buy-in from the people who ultimately use it.”

The success of the SHRIMPS protocol highlights the significant impact that quality improvement programs can have in healthcare: by implementing standardized handoff protocols, operating rooms can achieve better communication, fewer errors and better patient care, the authors note. The study authors advocate for the widespread adoption of such tools to ensure reliable and efficient information transfer in surgical environments.