Assessing the White's Fast-Track Score for Postoperative Handoff Between the Operating Room and the Postanesthesia Care Unit.

Abstract

Purpose: The purpose of this project was to assess the sustainability of a standardized nursing postoperative handoff based on the White's Fast-Track Score (WFTS) tool used between the operating room (OR) and the postanesthesia care unit (PACU).

Design: This quality improvement project used an observational pre-post design using two separate samples of the OR circulating registered nurses (RNs) and the PACU RNs.

Methods: The project was conducted in a single OR that performs endocrine surgeries. Handoffs between the OR and PACU RNs using the WFTS tool were evaluated pre and post reintroduction of the tool. Data collected included percentage of handoff items communicated, duration of handoff, and staff satisfaction pre and post implementation.

Findings: The use of the WFTS tool significantly improved the handoff communications, with reported items increasing from 66.0% to 97.3%. Handoff duration in minutes was reduced from pre implementation (M = 1:13, SD = 0:43) to post implementation (M = 0:55, SD = 0:38), t(63) = 1.70, P = .094, staff satisfaction scores improved, especially in clarity and comprehensiveness of handoffs, with significant increases in mean rank scores for items such as "Guidance on the expected postoperative course" (Mdn = 2.5 to Mdn = 3.1) and "Overall handoff communication" (Mdn = 2.5 to Mdn = 3.2).

Conclusions: The implementation of the WFTS tool significantly improved handoff communication between OR and PACU nurses, as evidenced by increased accuracy in reported items and maintained handoff duration. Ongoing staff training and consistent use of the tool are essential in sustaining these benefits. Future efforts should focus on addressing challenges such as inconsistent application and expanding the use of structured handoff tools to other surgical specialties for ensuring long-term improvements in patient care and staff satisfaction.