This past year I have been working on “HATRICC Champions.” My qualitative research project, HATRICC Champions is an offshoot of the Handoffs and Transitions in Critical Care (HATRICC) study, a project aimed at evaluating and changing clinician communication behavior in operating room to intensive care unit transfers.
As part of my observations of handoffs, I noted that some clinicians were unusually supportive of the new HATRICC standardize handoffs. The clinicians, who I call “champions,” seem to understand and embrace the process, and encourage other clinicians to use it. HATRICC champions improve the quality of patient handoffs by taking lead in handoff communication by guiding the rest of the team of clinicians (ICU nurses, ICU attendings/residents, advanced practitioners, surgery and anesthesia attendings/residents, etc.) through the HATRICC handoff process, making sure all the clinicians participate fully in patient handoffs.
HATRICC does not offer incentives for clinicians to use the handoff framework in their clinical practice. However, HATRICC champions continue to promote the use of HATRICC’s standardized framework and are very effective spreading and further implementing HATRICC on hospital floors. They also strongly influence other clinicians to use HATRICC. I wanted to understand the factors, motivations, and underlying causes that engage champions to promote and continue implemented frameworks developed by research even after the research study is finished.
Through conducting interviews and pilots, I have discovered that nurses play a crucial role in bringing clinicians from the OR and ICU together into a huddle and starting the information transfer. They are often the leaders of handoffs. The reason that they are so onboard with HATRICC’s standardized process is because they believe the handoff process allows them to better care for their patients. The electronic medical records can only tell so much about the patient’s conditions, complications, and surgical procedures. By bringing the OR and ICU team together to conduct an information handoff, there is less time spent on trying to track down residents are physicians to find out information, especially when the OR team just drops off a patient without letting the ICU team know. For the rest of the fall semester, I will continue to interview clinicians such as nurses, nurse anesthetists, residents and attending physicians to uncover further themes that has the potential to advance understanding of healthcare intervention uptake.