The new transfer protocol enhances surgical safety

A new study shows a successful quality improvement program that significantly improves surgical safety. By applying a standardized handover protocol, known as SHRIMPS, the study shows how effective communication in operating rooms (ORs) can reduce the risk of errors and improve patient care. The findings are published in Journal of the American College of Surgeons (JACS).

This study is a prime example of how quality improvement initiatives can lead to better outcomes for patients. By standardizing communication during surgery, we can ensure that all team members are informed and that critical information is conveyed consistently, reducing the risk of errors.”

Madeline Anderson, DO, co-author of the study, Surgical resident at the University of Kentucky

Prompted by a frontline stakeholder’s concerns about inadequate quality handoff of surgical techniques, the quality improvement (QI) team at the Lexington VA Medical Center, affiliated with the University of Kentucky Hospital, developed an audit tool to assess handoffs in various surgical cases from May 2022 to February 2024. Initial audits revealed that handovers were made in 82.6% of cases, but only 34.4% of critical information was shared.

In response, the team, in collaboration with OR staff, developed a standardized communication checklist with the acronym “SHRIMPS” (Sharps, Sponges, Hidden or held items, Replaced items, Instruments & Implants, Medics, Procedure Overview, Specimes) . Although it has nothing to do with the crustacean, the team chose the acronym SHRIMPS to be a useful mnemonic device for surgical teams. This checklist was prominently displayed in all ORs at the Lexington VA Medical Center.

Important findings

• Prior to the implementation of SHRIMPS, handovers occurred 82.6% of the time, with only 34.4% of critical items shared.

• After implementation of SHRIMPS, 100% of cases involved handovers, with 98.2% of critical items addressed.

• Handoffs averaged 69.4 seconds after implementation, ensuring thorough communication without a significant increase in handoff time.

“Part of the success of SHRIMPS comes from the QI team engaging with both front-line and first-line stakeholders, including surgical technicians and circulating nurses,” said Dr. Anderson. “This approach ensures that the tool is more effective and garners buy-in from the people who end up using it.”

The success of the SHRIMPS protocol highlights the significant impact that quality improvement programs can have on healthcare – by implementing standardized handoff protocols, surgeries can achieve better communication, fewer errors and improved patient care, the authors note. The study authors support the widespread adoption of such tools to ensure reliable and efficient information transfer in surgical settings.