Changes in Efficiency and Safety Culture After Integration of an I PASS Supported Handoff Process
BACKGROUND AND OBJECTIVES: Recent publications have shown improved outcomes associated with resident to resident handoff processes. However, the implementation of similar handoff processes for patients moving between units and teams with expansive responsibilities presents unique challenges. We sought to determine the impact of a multidisciplinary standardized handoff process on efficiency, safety culture, and satisfaction. METHODS: A prospective improvement initiative to standardize handoffs during patient transitions from the cardiovascular ICU to the acute care unit was implemented in a university affiliated children's hospital. RESULTS: Time between verbal handoff and patient transfer decreased from baseline (397 167 minutes) to the postintervention period (24 21 minutes) (P .01) Percentage positive scores for the handoff/transitions domain of a national culture of safety survey improved (39.8% vs 15.2% and 38.8% vs 19.6% P .005 and 0.03, respectively) Provider satisfaction improved related to the information conveyed (34% to 41% P .03) time to transfer (5% to 34% P .01) and overall experience (3% to 24% P .01) Family satisfaction improved for several questions, including: "satisfaction with the information conveyed" (42% to 70% P .02) "opportunities to ask questions" (46% to 74% P .01) and "Acute Care team's knowledgeabout my child's issues" (50% to 73% P .04) No differences in rates of readmission, rapid response team calls, or mortality were observed. CONCLUSIONS: Implementation of a multidisciplinary I PASS supported handoff process for patients transferring from the cardiovascular ICU to the acute care unit resulted in improved transfer efficiency, safety culture scores, and satisfaction of providers and families.
Pediatrics