Ipass medical handoff
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All components of the resident handoff bundle were implemented at the end of September along with a follow-up session in November. Preimplementation data were collected for 27 weeks from April through September 2019. A one-page summary of sign-out template and I-PASS instructions was attached to the wall in the inpatient team staff room. After each session, we also sent a follow-up email with a summary of the training content. 12 The Institutional Quality Improvement Review Committee approved this study.įor the intervention, we introduced the I-PASS structure through two 20-minute didactic lectures and on-the-job training sessions in September and November 2019. We conducted an observational study with 29 family medicine residents in a family medicine residency training program at an urban hospital. 6 We hypothesized that a standardized handoff process for resident sign-out would (1) reduce preventable unexpected floor calls, (2) improve residents’ confidence to care for patients overnight through better handoffs, and (3) reduce preventable adverse events. 11 In a 2014 multicenter study, the I-PASS Handoff Bundle implementation was shown to reduce preventable adverse events. 6,10 The I-PASS mnemonic provides a framework for patient handoff as follows: Illness severity, Patient summary, Action list, Situation awareness and contingency planning, Synthesis by receiver. We selected the I-PASS Handoff Bundle because it is the most validated method for handoffs. Our family medicine residency program did not have a standardized overnight sign-out process. 5 Residency programs in other subspecialties, including pediatrics and internal medicine, have implemented standardized transition-of-care processes for the inpatient setting, although assessment of these quality improvement measures remains ongoing and data from family medicine are lacking.
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4 The Accreditation Council for Graduate Medical Education (ACGME) mandates resident training in effective transitions of patient care and emphasizes the importance of managing handoffs to comply with new recommendations for resident duty hours. Patient handoffs between residents have become more frequent because of duty hour restrictions. 2 For example, a 2009 systematic review found that omitted information and incorrect information were common at patient care handoff. 1 Ineffective or incomplete transitions of care can negatively impact both patients and physicians by contributing to potential miscommunication and errors, or by compromising resident confidence. However, the intervention did not improve residents’ reported confidence and preparedness to care for patients overnight.Ĭommunication error is a leading cause for sentinel events. However, the intervention did not significantly affect residents’ confidence level in caring for patients overnight and residents’ rating of the usefulness of anticipatory guidance for managing night floor calls. We did not identify any medical errors related to communication issues at patient handoff within the family medicine service.Ĭonclusion: I-PASS intervention significantly reduced unexpected floor calls. Results: Prior to the I-PASS intervention, more than half of resident surveys included at least one unexpected floor call whereas postintervention about one-third of resident surveys included unexpected floor calls (P<.05). We evaluated the effectiveness of the I-PASS Handoff Bundle by comparing pre- and postimplementation data including number of medical errors and unexpected floor calls, along with residents’ reported levels of preparedness and confidence to care for patients overnight. Residents received trainings in the I-PASS standardized handoff through didactic lectures and on-the-job sessions in September and November 2019. Methods: We conducted an observational study at a single-site family medicine residency between April 2019 and March 2020. We aimed to reduce preventable adverse events and unexpected floor calls while also improving residents’ confidence and preparedness to care for patients overnight. We introduced the I-PASS Handoff Bundle for resident sign-out in the inpatient setting. A structured handoff is an effective communication tool. Introduction: Handoff miscommunications are a leading cause of medical errors.