Structured Intraoperative Patient Handover among Anesthesia Providers and Its Role in Patient Safety and Team Communication: A Systematic Review

Mohammad Mehdi Azizi Darbandi; Mohammad Gholamzadeh; Alireza Mamizadeh; Zahra Ranjbar; Behnam Shiri Zilan

doi:10.18502/aacc.v12i3.21318

Mohammad Mehdi Azizi Darbandi Department of Anesthesia & Surgical Technology, School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia, Iran.
Mohammad Gholamzadeh Department of Anesthesiology, School of Allied Medical Sciences, Golestan University of Medical Sciences, Gorgan, Iran.
Alireza Mamizadeh Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
Zahra Ranjbar Department of Anesthesiology and Operating Room, School of allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.
Behnam Shiri Zilan Department of Anesthesia & Surgical Technology, School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia, Iran.

DOI: https://doi.org/10.18502/aacc.v12i3.21318

Keywords: Intraoperative handoff; Intraoperative handover; Anesthesia provider; Structured handoff; patient safety; Communication; Operating room

Abstract

Background: Intraoperative handovers, the transfer of patient care between anesthesia providers, are common in the operating room and represent a critical juncture for communication failures. Ineffective handovers are associated with the loss of essential clinical information and an increased risk of adverse postoperative outcomes. This systematic review aimed to synthesize the existing evidence regarding the impact of structured intraoperative handovers on patient safety, communication quality, and continuity of care.

Methods: This systematic review was conducted according to the PRISMA guidelines. The study evaluated 17 published research studies (2000–2025) investigating structured intraoperative anesthesia handovers, including the utilization of checklists, SBAR (Situation-Background-Assessment-Recommendation), I-PASS, and cognitive aids. Data extraction focused on patient safety outcomes, communication quality, and the continuity of care.

Results: The findings demonstrate that non-standardized handovers commonly result in information loss and variability in clinical practice, thereby potentially compromising patient safety. In contrast, the use of standardized handover tools reliably promotes information transmission, bolsters team collaboration, and minimizes variability in patient-transfer procedures. Moreover, available data suggest that implementing structured intraoperative handovers is associated with reductions in postoperative morbidity, although study findings are heterogeneous.

Conclusion: Structured intraoperative handovers are a viable and economical technique to improve communication and patient safety under anesthesia. Standardization and targeted education may further optimize the outcomes. Future research should identify the optimal handover components, evaluate their long-term clinical impact, and guide the development of international implementation strategies.