1. I-CATCH: A Novel Bundle to Improve Postcall Morning Handoffs.
- Author
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Zipursky JS, Dhhar G, Weinerman A, Stroud L, and Wong BM
- Subjects
- Academic Medical Centers, Communication, Hospitals, Teaching, Humans, Ontario, Patient Handoff organization & administration, Quality Improvement, Internal Medicine standards, Internship and Residency, Patient Handoff standards
- Abstract
Background: Conducting postcall morning handoffs using a resident handoff bundle such as I-PASS can prove challenging. This may delay recognizing and acting on clinically important patient issues that arose overnight., Objective: We developed and implemented the I-CATCH morning handoff bundle and evaluated its impact on the proportion of overnight patient issues handed off from the on-call resident to the daytime team., Methods: We evaluated the I-CATCH ( I dentify patient; C haracterize situation; A ction-what was done overnight?; T o do for the team in the morning; C onfirm the H andoff) handoff bundle from November 2015 to May 2016 on general internal medicine wards at 1 academic teaching hospital. The bundle entailed staff/resident training, structured communication, and dedicated handoff space and time. We compared handoffs of overnight on-call issues by evening resident to daytime medical team before and after implementation, and used statistical process control to analyze adherence to the mnemonic., Results: We observed 435 handoffs (242 pre- and 193 postimplementation) over 63 days. There was no significant association between I-CATCH implementation and proportion of on-call overnight issues handed off (OR = 0.96; 95% confidence interval [CI] 0.52-1.47; P = .85). Running the list by going through patients one-by-one (OR = 1.74; 95% CI 1.1-2.77; P = .019), progress note documentation (OR = 3.80; 95% CI 2.19-6.60; P < .001), and direct handoff (OR = 4.84; 95% CI 1.43-16.42; P = .011) correlated with an increased likelihood of morning handoff., Conclusions: Implementing the I-CATCH bundle did not improve handoff of overnight issues to the daytime team., Competing Interests: Conflict of interest: The authors declare they have no competing interests.
- Published
- 2018
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