HATRICC: Handoffs and Transitions in Critical Care


COL 2022


Associate Professor of Anesthesiology and Critical Care & Epidemiology

Project Summary

For ten weeks, I experienced the world of clinical research as part of the ongoing study HATRICC, Handoffs and Transitions in Critical Care.

HATRICC was implemented as a standardized process providing a new structure for handoffs from the Operating Room to the Intensive Care Unit. For this interventional study, I spent my time between the Trauma Surgical and Surgical ICU at the Penn Presbyterian Medical Center and the Hospital of the University of Pennsylvania. I did my research observing handoffs as patients were transitioned from the surgical team to the ICU team.

The handoff period is a crucial and time-sensitive window. It involves four key players: the surgeon, anesthetist, registered nurse and ICU provider. The transmitting team from the Operating Room gives pertinent information about the post-operation patient to the receiving ICU team, and together, they develop a plan of care. This conversation occurs at the patient bedside, and since the implementation of HATRICC in 2014, the information exchange between teams has significantly improved.

During my observations of the handoffs, I used a quantitative assessment tool and audio recording device to capture patient and clinician data in ICU rooms while handoffs occurred at the patient bedside. Post-handoff, I inputted data into the Research Electronic Data Capture (REDCap) tool and used the Electronic Medical Record at the hospital for relevant information.

In addition to quantitative data, I also noted salient qualitative aspects such as explanations of ICU congestion and team professionalism. My collected research falls within our project’s Sustainability Phase, which is essential to track the long-term effects of our intervention and to adapt to inevitable changes in the hospital system.

Though intimidating at first, I grew increasingly familiar with the ever-changing ICU workflow, and I trained to hone my observation skills of my surroundings. Each patient observed was a unique case, and I gained valuable insights about teamwork in the interdisciplinary healthcare system.

Under the umbrella of the HATRICC project, I was also given opportunities to help with a Systematic Review and Interdisciplinary Communication project. Through the Systematic Review, I was exposed to the detailed oriented process of sifting through academic publications. In the Interdisciplinary Communication project, I had the interactive job of meeting and interviewing all types of clinicians in the hospital system. Both projects were collaborative in nature, and I was able to form strong relationships with my older experienced research mentors.

HATRICC has been a valuable introduction into healthcare research. Due to the exceptional mentorship of my PI and research staff, I have grown immensely, and I will treasure this summer experience which I know will undoubtably help me in the future career I pursue.