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Surgical Suite to Pediatric Intensive Care Unit Handover Protocol: Implementation Process and Long-term Sustainability

Northway, Tracie MSN, RN; Krahn, Gordon RRT; Thibault, Kristine BScN, RN; Yarske, Lisa BScN, RN, CNCCP(C); Yuskiv, Nataliya MD, MPH; Kissoon, Niranjan MD, FRCP(C), FAAP, FCCM, FACPE; Collet, Jean-Paul MD, PhD

doi: 10.1097/NCQ.0000000000000093

The article reports the long-term sustainability of a standardized transfer protocol from cardiac surgical suite to the pediatric intensive care unit. Using rapid process improvement technique, the original mean defect rate per handover decreased from 13.2 to 0 and 0.3, 12, and 24 months postimplementation, respectively. This study stresses the importance of long-term assessment to control for possible observation biases; it also illustrates a successful implementation strategy that used video recording to engage staff in identifying solutions to the observed defects.

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Critical Care Unit, BC Children's Hospital and Sunny Hill Health Centre for Children, The University of British Columbia, British Columbia Canada (Mss Northway, Thibault, and Yarske, and Mr Krahn, and Drs Kissoon and Collet); Child & Family Research Institute, Vancouver, Canada (Drs Kissoon, Yuskiv, and Collet); and Department of Pediatrics, The University of British Columbia, British Columbia, Canada (Dr Kissoon and Collet).

Correspondence: Jean-Paul Collet, MD, PhD, BC Children's Hospital, The University of British Columbia; and Department of Pediatrics The University of British Columbia, CFRI V3-320-948 West 28th Ave, Vancouver, BC V6H 3N1 (

The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: September 17, 2014

Published ahead of print: November 25, 2014

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