Structured patient handoffs cut adverse effects by nearly 50%, researchers find

The I-PASS Handoff Program, created to improve handoff miscommunications when providers change shifts, resulted in a 47 percent reduction in adverse events, a new study found.

The study, published Nov. 3 in the Journal of Hospital Medicine, engaged 32 diverse hospitals that included adult, pediatric, academic and community hospitals. 

At each hospital, supervising physicians oversaw more than 3,000 patient handoffs before, during, and after program implementation and data collection. The I-PASS team also separately reviewed 1,620 written handoff documents. 

I-PASS, a package of communication and training tools, stands for illness severity, patient summary, action list, situational awareness/contingency planning, and synthesis of the information by the incoming provider — in other words, the information that needs to be passed on during handoffs. Boston Children's Hospital pediatricians Christopher Landrigan, MD, and Amy Starmer, MD, study authors and co-creators of the I-PASS system, were surprised to find the program's improvements were consistent across the board.

"Handoff is a universal issue in healthcare," Dr. Landrigan said in a Dec. 2 news release from Boston Children's. "We think we've created a universal language for handoffs. The challenge now is to implement the program at scale across hospitals."

The study also found improvements in the completeness and quality of handoff communications: 66 percent of verbal handoffs were completed, and incoming providers were able to give a high-quality synthesis of information they received 83 percent of the time. Written handoffs were complete 74 percent of the time. 

These findings come after a 2014 study in the New England Journal of Medicine, in which Dr. Starmer, Dr. Landrigan and colleagues implemented I-PASS at children's hospitals. Though they found improved communication and a 30 percent reduction in serious, preventable medical errors, they wanted to see if it would work with adults and in other types of hospitals. 

Now, they want to expand the I-PASS program by co-founding a startup company, I-PASS Patient Safety Institute. The company is working with about 50 hospitals to launch handoff programs at scale and offering training, cloud-based tools and support for medical records systems. 

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