The I-PASS Study began in January 2010 and ended in May 2013 and was conducted in conjunction with the Pediatric Research in Inpatient Settings (PRIS) network and the Initiative for Innovation in Pediatric Education (IIPE), with funding from the Department of Health and Human Services. 2.5 minutes, p=0.55) or resident workflow, including patient-family contact or computer time. There were no significant changes in the duration of oral handoff per patient (2.4 vs. As evidence of successful implementation, significant increases across all sites were observed in inclusion of key information in written handoff documents (improvements in 9 of 9 pre-specified key elements) and in verbal communications during handoffs (5 of 5 key elements) (p<0.001 for all 14 comparisons). Following implementation of the I-PASS Handoff Bundle across 10,740 patient admissions, we found that medical errors decreased by 23% (24.5 vs 18.8 per 100 admissions, p<0.001) and preventable adverse events-medical errors resulting in harm to patients- decreased by 30% (4.7 vs 3.3 per 100 admissions, p<0.001). The I-PASS mnemonic is integrated throughout each curricular module as a framework and way of standardizing the handoff process.Īcross nine data collection sites, we conducted a prospective intervention study, the I-PASS Study, to assess the relationship of implementing the I-PASS Handoff Bundle to medical error rates ( Starmer et al, NEJM 2014). A cornerstone of the curriculum is I-PASS ( Starmer et al, Pediatrics 2012), a mnemonic for the key elements of the handoff process: I: Illness severity P: Patient summary A: Action items S: Situation awareness and contingency planning S: Synthesis by receiver.
The I-PASS Handoff Bundle, includes a comprehensive suite of educational materials with six major complementary components. To develop the I-PASS Handoff Bundle for use in the multi-site study, we applied a rigorous approach to curriculum development ( Starmer et al, Academic Medicine 2013). Informed by a single institution pilot study ( Starmer et al, JAMA 2013), the I-PASS Study was launched, an eleven-center handoff intervention study ( Sectish et al, Pediatrics 2011). To address this gap, we developed the I-PASS Handoff Bundle, an evidence-based, standardized approach to teaching, evaluating, and improving handoffs.
Despite these requirements and concerns, effective handoff curricula and methods to ensure that trainees acquire handoffs skills are lacking. Recognizing the role of handoff failures in medical errors, the Accreditation Council for Graduate Medical Education (ACGME) now requires all training programs to teach resident physicians handoff skills and to monitor the quality of handoffs. Joint Commission and the Department of Defense as a contributing cause in approximately two out of every three sentinel events – serious, often fatal, preventable adverse events in hospitals. Members, Partner Institutions and OrganizationsĬommunication and handoff failures are both common and hazardous, and have been identified by the.Patient and Family Centered I-PASS Research Study.