A 'blueprint' for change: 7 things to know about Mass General's implementation of a patient handoff system

While healthcare leaders and researchers have identified improving care handoffs as a critical component for reducing preventable errors and improving patient safety, hospitals encounter substantial challenges when attempting to implement standardized handoff procedures across disciplines and workflows.

 

A recent editorial published in BMJ Quality & Safety examines a study of how Massachusetts General Hospital in Boston standardized care handoffs across the hospital.

Here are seven things to know about Mass General's effort to standardize handoffs.

1. To address safety issues created by healthcare's increasingly complex care delivery models, a multidisciplinary team at Mass General implemented the I-PASS handover system hospitalwide, according to a study published in BMJ Quality & Safety in April.

2. In an earlier study published in the New England Journal of Medicine, the I-PASS handover system was associated with a 30 percent reduction in preventable adverse events. The intervention included handoff and communication training and a faculty observation program.

3. The first phase of Mass General's hospitalwide implementation of the handoff system was conducted from 2013 to 2016 and involved training of more than 6,000 physicians, nurses and therapists, according to the study.

4. The effort at Mass General was successful at improving the percentage if I-PASS handoff adherence. However, adherence to certain aspects of the program was lower than others.

5. In their editorial, Maitreya Coffey, MD, and Lennox Huang, MD, of The Hospital for Sick Children in Toronto, make the case for the importance of the Mass General study, arguing the study has "given us a blueprint for how to achieve change in a complex environment."

6. "Many individuals and organizations find themselves wishing, planning or attempting to implement standardized handoff organization-wide, but find it challenging, if not Herculean, to do so," write the editorial's authors. "It is rare to encounter a hospital which has successfully implemented and evaluated standardized handoff across the full scope of disciplines, subspecialties and workflows. [The authors] have provided an account of how they anticipated and endeavored to address many of the factors that make it difficult to achieve organization-wide standardized handoff. We feel they have key messages with broad relevance to the patient safety and quality improvement communities."

7. The second phase of the effort to improve consistent, sustainable adoption of the I-PASS handoff system at Mass General is ongoing.

To read the Mass General study, click here.

To read the BMJ editorial, click here.

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