Objective: To use forensic interview techniques to compare information used by expert clinicians at handover of critically ill children following cardiopulmonary bypass and cardiac surgery. Analysis of features from interviews is used to construct a handover checklist of important information for use at handover by non-expert staff.
Methods: Approval was obtained from the Local Research and Ethics Committee for this study. Four groups (anaesthetists, surgeons, intensivists and nurses) expert in the care of postoperative cardiac cases at our institution were identified. Two researchers (LC, JdP) interviewed three experts from each group using a semi-structured cognitive interview protocol used previously in forensic investigations.
All interviews were recorded and later transcribed for analysis by two independent raters. Features relating to shared information during patient handover from theatre to intensive care were extracted. These were subsequently compiled into a checklist following similar lay-out guidelines used in other high-risk industries, eg aviation.
Results: Overall reliability of initial feature extraction between raters was satisfactory (69.1% agreement). Raters achieved subsequent consensus on all remaining features. Anaesthetists generated the greatest number of features. Fourteen features were common to all expert groups. All identified features were incorporated into a chronologically-ordered checklist for use at handover by non-expert staff.
Conclusions: The cognitive interview technique demonstrates similarities and differences between expert groups caring for postoperative cardiac babies and children, and allows mapping of both common and distinctive features. Identified features are useful in developing a handover tool to assist transfer of necessary information. This may lead to improved patient safety.