Handoff program cuts medical errors by 40%

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A handoff process called I-PASS, developed by Boston Children's Hospital, can reduce medical errors by as much as 40 percent, according to physicians at the Pediatric Academic Societies annual meeting in Boston. Ten pediatric training programs in North America are testing the model.

The patient safety and medical education initiative standardizes patient handoffs during shift changes, according to the research announcement yesterday. In the I-PASS model, clinicians trained in communication and teamwork skills using the Agency for Healthcare Research and Quality-developed TeamSTEPPS use a mnemonic device to convene key information:
I -- Illness severity
P -- Patient summary
A -- Action list for the next team
S -- Situation awareness and contingency plans
S -- Synthesis and "read-back" of the information

In addition, clinicians share a printed document during the handoff, integrated into the patient's electronic medical record. The documents include significantly more information, including a to-do list for the patient and medication lists.

Residents receive a three-hour training workshop in the model, and senior physicians directly observe the structured handoff and offer feedback.

In addition to cutting medical errors from 32 percent of admissions to 19 percent, handoffs were twice as likely to occur in a private or quiet location, according to Boston Children's Hospital. Physicians also spent more time with patients (225 minutes per 24-hour period, compared to 122 minutes) and less time on the computer (370 versus 408 minutes).

For more information:
- read the press release
- visit the I-PASS study website

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