Supervising physicians at each hospital oversaw more than 3,000 patient handoffs before, during, and after program implementation and collected data. However, to simulate real-world conditions, the I-PASS team provided much more limited financial and administrative support than in the 2014 study. They also provided outside coaching to help hospitals implement the program. The researchers enrolled both residents and “faculty champions,” who are key to the successful adoption of I-PASS. The new study engaged 32 diverse hospitals - adult, pediatric, academic, and community hospitals. “We wanted to know whether the program would be similarly effective and feasible in a more ‘real-world’ setting, with for a broader variety of providers and patients,” says Landrigan. But would I-PASS work with adult patients and in other types of hospitals? Following up, they found improved communication and a 30 percent reduction in serious, preventable medical errors. In their first major study, published in The New England Journal of Medicine in 2014, Starmer, Landrigan, and colleagues implemented I-PASS at nine academic children’s hospitals. “We wanted to add structure to what was an unstructured and sometimes haphazard process,” explains Starmer, now associate medical director of quality in the Division of General Pediatrics. S: Synthesis of the information by the incoming provider S: Situational awareness/contingency planning I-PASS revolves around a simple mnemonic that specifies information to be exchanged during handoffs: Results were striking: over a three-year period, adverse medical events were reduced by nearly half. In a study published in the Journal of Hospital Medicine last month, they put I-PASS to the test in a diverse group of hospitals. It consists of a package of communication and training tools that prompt providers to pass on crucial information - both verbally and in writing - in a reliable, structured fashion. Wanting to improve this process, Starmer and Landrigan created the I-PASS Handoff Program. Providers finishing a shift may be tired and rushed and more apt to omit key information important to the patient’s care. And handoffs are especially prone to communication lapses. Miscommunication contributes to about two thirds of serious adverse events in hospitals, according to the Joint Commission, a leading healthcare quality organization. “They are a common source of vulnerability for patients.” “Patients who are admitted to the hospital typically have multiple teams of providers caring for them, so these periods of information handoff occur frequently throughout their stay,” says Landrigan, now chief of the Division of General Pediatrics at Boston Children’s. Yet such structured communication was largely absent at a critical time: during shift changes when patients’ care was handed off to new providers. Medical residents were rigorously trained to take patient histories with standardized templates and to present cases in a structured format during daily rounds. (Images: AdobeStock / Illustration: Patrick Bibbins)Ībout 15 years ago, Boston Children’s Hospital pediatricians Christopher Landrigan, MD, MPH, and Amy Starmer, MD, MPH, observed a weak link in hospital care. Studying for Step 3? Here's the most useful resources.Across 32 diverse hospitals, a system of structured communications during patient handoffs reduced adverse events by 47 percent. UCSD Practical guide to clinical medicine Links for help with getting through residency: No links or images linking to the NP or PA subs posted for targeted harassment. No targeted harassment against individuals or organizations.Ĩ. No personal agendas, spam, or links to websites for brigading.ħ. B) If you message the moderators about a removed post you must link the post in your message or will be ignoredĦ. A) New and anonymous accounts are welcome but posts and comments may be delayed as they must be approved manually.ĥ. No protected health information or personal information.ĥ. No questions about applying to residency or medical school. No questions pertaining to medical school. No "What are my chances?" or similar threads. If you have any suggestions to make the sub better, please message the moderator.Ģ. Welcome to the Residency subreddit, a community of interns and residents who are just trying to make it through! This is a sub dedicated to resident physicians in training.
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