Abstract: Background – Patient handoff between caregivers presents opportunities for the incomplete transfer of information or responsibility of care. Employment of structured patient handoff tools have been shown to improve patient outcomes as well as increase rounding efficiency.
Objective – To describe the development, implementation and impact of an I-PASS based patient handoff system in 100 emergency and specialty hospitals.
Methods – An organizational-wide quality improvement initiative was developed based on TeamSTEPPS communication training utilizing the I-PASS patient handoff tool. Both verbal as well as a written rounds document were recommended. Hospitals were asked to create champion teams to aid in implementation and self-auditing processes.
Results – Over half of all hospitals (54/100) voluntarily adopted the use of I-PASS for patient hand offs. The initiative took on a wide variety of forms based on hospital culture, hospital structure and schedule, and level of engagement. Challenges included the perceived redundancy of a written rounds document, pre-established doctor schedules, and the required changes to workflow.
Fifty-one percent (51%) of survey respondents described their hospital’s handoff format as moderately or extremely efficient post initiative. Seventy-eight percent (78%) described rounds as extremely efficient when the same format was used each time. Vital information was omitted less often by hospitals employing I-PASS than those that did not.
Conclusions – Structured patient handoffs that utilize a consistent format improve rounding efficiency and ensure vital information is not omitted. Adoption requires logistical and cultural shifts. Greater use of structured patient handoffs could positively impact patient safety.
