Appendix 1. Final Codebook with Definitions

Code Name / Definition
AdverseEvent / Any mention of consequences due to poor handoffs (for example, inappropriately coding someone who is DNR, OR mention of code status, unnecessary treatment, unnecessary testing, clinical instability resulting from poor communication, delays in diagnosis, cardiac arrest, stroke, death).
Barriers / Anything that interferes with giving or receiving OR-to-ICU handoffs.
FindingPeople / Any mention of needing to find people in order to give handoffs, mention of the right person arriving with the patient to the ICU, or mention of team contact (or lack of). Also, any mention of certain providers being absent from ICU room during handoff.
HumanError / Any mention of issues due to human error (for example, forgetting information, being tired, having to repeat information). Does NOT include lack of information due to resident transporting case he or shedidn’t participate in.
InformationContinuity / Any mention of misinformation, changes in care plan, information change between providers. (Also, any mention of patient transfer done by junior residents, inexperienced, didn’t have access to right information.)
Prioritization / Other obligations that might interfere with handoff being given (for example, other patients, meetings, handoff interruptions, etc.). Where does handoff fall on a list of things to do? How important is it relative to other tasks? What are competing priorities?
ShiftWork / Problems with going on and off shift—effects on handoffs. Shifts, shift work, mention of duty hours for residents or fellows, limits on hours.
TimeConstraints / Not having enough time, length of handoff, nonclinical time, dedicated time, INCLUDING coordinating a time, working around rotation schedules.
CurrentHandoffQuality / Any mention of what current, good handoffs look like as a whole. Does NOT include any mention of the content that should be discussed during a handoff or description of handoff standardization.
HandoffContentExclusion / Any mention of items that are not relevant to a handoff/patient’s care or should not be included in a handoff.
HandoffContentInclusion / What items should be discussed; for example, “hemodynamics,” “lines,” etc. What people should be present?Examples/expectations of handoff content. Anything that makes a handoff better, facilitates the process. “I don’t think anything should be excluded.”
HandoffImplementation / Any suggestions about how to implement new handoff structure, how participants want to see it done. “Training,”“e-mails,” etc. Does NOT include whether or not participants want to see a new standardized handoff.
HandoffStructure / Any mention of what people want the IDEAL handoff to look like (not what it currently looks like). Includes mention of standardization or discussion/examples of handoff template and what the process looks like as a whole.
PriorExperience / Any mention of prior experience with handoffs in previous workplaces. Variability of structure between hospitals.
HandoffImportance / Any mention about whether or not participants consider handoffs worthwhile. Includes discussion of peer views as well.
MemorableQuote / Anything that sticks out to you that might be good to quote in presentations or published reports.
NewProcessAcceptability / How open are people to a new standardized system? How open do they think their peers would be?
NewProcessCons / Any mention of why a new checklist or protocol would be a bad idea and examples.
NewProcessPros / Any mention of why a new checklist or protocol would be a good idea and examples.
TeamworkandCommunication / How well do people know the people with whom they’re working? Do they feel like a team? Good/bad relationships. Any mention of issues, problems, what works well, what doesn’t. “On the same page,” “aware,” “respect.” Do people work toward a common goal?
Technology / EMR, phone calls, computers, etc. (their role in handoffs).
Training / Any mention of handoff training received, the length, when they were given it, or whether or not they’ve trained others. Does NOT include “no” answers in response to whether or not participant has trained other person unless there is some type of detailed answer. It does include “yes” responses with explanation.

DNR, do not resuscitate; OR, operating room; EMR, electronic medical record.