Enhancing Communication in Local Anesthetic ‎Handoffs:Implementation of An Sbar-Based ‎Handoff Form

Abstract

Local anesthetic systemic toxicity (LAST) is a rare but potentially fatal complication resulting ‎from unintended systemic absorption of local anesthetics, potentially exacerbated by ‎communication failures during perioperative handoffs. Standardized communication frameworks, ‎such as the Situation–Background–Assessment–Recommendation (SBAR) model, support safer ‎transitions of care. This quality improvement project implemented a standardized SBAR-based ‎local anesthetic handoff tool to improve interdisciplinary communication and reduce variability in ‎dose reporting among perioperative staff. Guided by a Plan–Do–Study–Act framework, the ‎project was conducted over 12 weeks at a 626-bed acute care facility. A total of 144 ‎perioperative handoff evaluations were completed using the SBAR tool and assessed with the ‎Handoff Clinical Evaluation Exercise (CEX), which evaluates organization, content, ‎communication, and clinical judgment. Data were analyzed using descriptive statistics and ‎nonparametric tests, including Kruskal–Wallis and Wilcoxon signed-rank analyses. Following ‎implementation, median total Handoff CEX scores were consistent across the preoperative, ‎intraoperative, and postoperative phases, at approximately 36. No statistically significant ‎differences were identified between sender and receiver scores (p = 0.612) or satisfaction ratings ‎‎(p = 0.831), indicating agreement among providers regarding handoff quality and tool usability. ‎Although overall scores remained stable, the SBAR-based tool promoted consistent inclusion of ‎critical dosing and safety information during perioperative handoffs. These findings suggest that ‎structured communication tools can enhance reliability in high-risk medication communication ‎and provide a sustainable framework to support patient safety and prevention of LAST in high-‎volume surgical settings‎.