1. Implementation of the I-PASS handoff program in diverse clinical environments: A multicenter prospective effectiveness implementation study.
- Author
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Starmer, Amy, Spector, Nancy, OToole, Jennifer, Bismilla, Zia, Calaman, Sharon, Campos, Maria-Lucia, Coffey, Maitreya, Destino, Lauren, Everhart, Jennifer, Goldstein, Jenna, Graham, Dionne, Hepps, Jennifer, Howell, Eric, Kuzma, Nicholas, Maynard, Greg, Melvin, Patrice, Patel, Shilpa, Popa, Alina, Schnipper, Jeffrey, Sectish, Theodore, Srivastava, Rajendu, West, Daniel, Yu, Clifton, Landrigan, Christopher, and Rosenbluth, Glenn
- Subjects
Adult ,Humans ,Child ,Patient Handoff ,Internship and Residency ,Prospective Studies ,Internal Medicine ,Communication - Abstract
BACKGROUND: Handoff miscommunications are a leading source of medical errors. Harmful medical errors decreased in pediatric academic hospitals following implementation of the I-PASS handoff improvement program. However, implementation across specialties has not been assessed. OBJECTIVE: To determine if I-PASS implementation across diverse settings would be associated with improvements in patient safety and communication. DESIGN: Prospective Type 2 Hybrid effectiveness implementation study. SETTINGS AND PARTICIPANTS: Residents from diverse specialties across 32 hospitals (12 community, 20 academic). INTERVENTION: External teams provided longitudinal coaching over 18 months to facilitate implementation of an enhanced I-PASS program and monthly metric reviews. MAIN OUTCOME AND MEASURES: Systematic surveillance surveys assessed rates of resident-reported adverse events. Validated direct observation tools measured verbal and written handoff quality. RESULTS: 2735 resident physicians and 760 faculty champions from multiple specialties (16 internal medicine, 13 pediatric, 3 other) participated. 1942 error surveillance reports were collected. Major and minor handoff-related reported adverse events decreased 47% following implementation, from 1.7 to 0.9 major events/person-year (p
- Published
- 2023