학술논문
Implementation of the I-PASS handoff program in diverse clinical environments: A multicenter prospective effectiveness implementation study.
Document Type
article
Author
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; Rosenbluth, Glenn
Source
Journal of Hospital Medicine. 18(1)
Subject
Language
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