@article{2809, keywords = {I-PASS, educational research, electronic handoff system, intervention, handoff, quality improvement, quality of care, resident education, residents, teaching hospital}, author = {Jasmine Walia and Zainab Qayumi and Nayaab Khawar and Beata Dygulska and Ilya Bialik and Carolyn Salafia and Pramod Narula}, title = {Physician Transition of Care: Benefits of I-PASS and an Electronic Handoff System in a Community Pediatric Residency Program.}, abstract = {

BACKGROUND: Miscommunication is a leading cause of adverse events in hospitals. Optimizing the handoff process improves communication and patient safety. We sought to assess how the components of I-PASS (a mnemonic for illness severity, patient summary, action list, situational awareness with contingency planning, and synthesis by the receiver), a standardized handoff bundle, improved the quality of handoffs in a pediatric residency program based in a community hospital.

METHODS: Pediatric residents in a university-affiliated community teaching hospital were observed on the pediatric inpatient floor and in the newborn nursery. One hundred resident handoffs per setting were analyzed in 3 phases, with a total of 600 handoffs assessed. Phase 1 comprised preintervention handoffs before I-PASS; phase 2, initiating I-PASS mnemonic and educational session; and phase 3, implementing a handoff tool, electronic physician handoff (EPH), into the electronic medical record. One attending physician at each setting assessed the handoff process using an 11-item survey. A resident satisfaction survey assessed the resident's experience after phase 3.

RESULTS: Comparing phase 1 with phase 2, there was improved situational awareness with contingency planning (nursery: 12% to 83%, P = .001; floor: 21% to 84%, P = .001). Incidence of tangential conversation decreased in both settings (nursery: 100% to 23%, P = .001; floor: 84% to 11%, P = .001). Comparing phase 2 with phase 3, there was improvement in identification of illness severity (nursery: 62% to 99%, P = .001; floor: 41% to 64%, P = .001) and fewer omissions of important information (nursery: 14% to 0%, P = .001; floor: 33% to 17%, P = .007). A total of 93% of residents found the new EPH system to be beneficial.

CONCLUSIONS: Specific components of a standardized handoff system, including a mnemonic, an educational intervention, and an EPH, improved the clarity and organization of key information in handoff.

}, year = {2016}, journal = {Acad Pediatr}, volume = {16}, pages = {519-23}, month = {12/2016}, issn = {1876-2867}, doi = {10.1016/j.acap.2016.04.001}, language = {eng}, }