TRAUMA QUALITY IMPROVEMENT
Using Intraoperative Trauma Video Review to Assess ED to OR Handoffs in Surgical Trauma Cases
Published on
Jul 1, 2025
Journal of Surgical Research
William Butak, BS; Chase Caswell, BS; Jaclyn Gellings, MD; Danielle Wilson, MD; Anna Tatakis, MD; Ruturaj Vala, BS; Amir Farah, MD; Christopher Jankowski, MD; David Milia, MD; Daniel Holena, MD, MSCE
Overview
This study examined the quality and consistency of emergency department (ED) to operating room (OR) handoffs in surgical trauma cases using intraoperative trauma video review as a novel data source. Recognizing that ED-to-OR handoffs are a high-risk transition in care and difficult to study with traditional methods, the authors analyzed audiovisual recordings from a dedicated trauma OR to assess adherence to their institutional Trauma Anesthesia Checklist (TAC). The primary objective was to characterize variability in the timing, duration, and content of handoffs, with particular attention to which checklist elements were underutilized and whether patient hemodynamic instability influenced handoff completeness.
Results
Across 43 trauma cases recorded over 12 weeks, ED-to-OR handoffs were brief and frequently incomplete, with a median duration of 36 seconds and only six of 18 possible checklist elements verbalized on average. While longer handoffs were modestly associated with more comprehensive information exchange, overall completeness remained low. Mechanism and extent of injury were the most consistently communicated elements, whereas many other critical components were often omitted. Contrary to the authors’ hypothesis, patient hypotension did not substantially reduce handoff completeness, except for increased attention to massive transfusion protocol communication.
The findings highlight ED-to-OR handoffs as a key opportunity for quality improvement and demonstrate that intraoperative trauma video review is a feasible and valuable method for evaluating real-world communication processes in emergent surgical care.
Peer-reviewed Research
