Project Details
About the Project
When a neonatal patient is scheduled for surgery, a team of clinicians from pediatric surgery, neonatology, and anesthesia need to work together. These surgical cases are usually high risk, with high stakes, making effective communication imperative. Prior to this Initiative, there was no standardized guidance at VGH on how to effectively communicate across both surgical and non-surgical teams. To address this, Dr Duncan McLuckie worked with a team of physicians including Dr Martina Mudri, Dr Al Hayashi, and Dr Elizabeth McGregor across Pediatric Anaesthesia, Pediatric Surgery, and Neonatology, as well as with allied care representatives, including Sharleen Steeper. They developed a flowchart, checklist, and communication tool to support community and ensure all concerns are addressed prior to patients’ transfer from the neonatal intensive care unit (NICU) to the operating room, and back again.
The team now engages in pre- and post-operative bedside huddles, to ensure pre-operative and intra-operative clinical pathways are thoroughly reviewed by each provider using specific prompts. Reflecting on this change of practice, Dr. McLuckie shared, “The integration of the flowchart, checklist, and the mandatory presence of all providers during handovers has significantly improved closed-loop communication.” Furthermore, it is clear the initiative fostered stronger collaboration between the operative and non-operative teams, ultimately enhancing patient care. The team used pre- and post-implementation surveys to assess provider support for this initiative, and the results were overwhelmingly positive. Challenges to set multidisciplinary rounds at fixed times remain from a scheduling perspective, but the team is committed to developing effective workarounds ot make sure this practice is sustained.