Resident Sign-out Clinical Trial
Official title:
Bundling Effective Resident Handoff Tools to Improve Patient Safety: A Multi-Center Pediatric Residency Quality Improvement Initiative
Because communication and handoff failures are a root cause of two-thirds of "sentinel events"- serious, often fatal preventable adverse events in hospitals improving handoffs has been identified by AHRQ and the Joint Commission as a priority in nationwide efforts to improve patient safety. Comparative Effectiveness Research on handoff tools and processes has identified specific strategies to improve handoffs and reduce medical errors: 1) team training; 2) verbal mnemonics; and 3) use of written/computerized tools to supplement verbal sign-outs. To accelerate residents' use of CER-based handoff practices and improve patient safety, the investigators are implementing the three inventions above as a Resident Handoff Bundle (RHB) in eight pediatric hospitals in the United States and Canada.
The I-PASS Study was initiated in response to mounting evidence that communication and
handoff failures are a root cause of two-thirds of "sentinel events" - serious, often fatal,
preventable adverse events in hospitals. The Agency on Healthcare Research and Quality
(AHRQ) and Joint Commission have identified improving handoffs in care as a priority in
nationwide efforts to improve patient safety. Research on handoff tools and processes has
identified team training, introduction of verbal mnemonics, and use of written or
computerized tools as strategies to improve handoffs and reduce medical errors. This study
was designed to evaluate the effect of a resident handoff bundle (RHB) comprised of these
three strategies in addressing medical errors, verbal and written miscommunications, and
resident workflow and satisfaction.
The US Department of Health and Human Services granted $3 million in funding, with
additional support provided by member institutional and private foundations. A total of nine
hospitals in the United States and Canada will serve as data collection sites for the study
(see list below). Staggered six-month waves of baseline data collection of medical errors
and resident workflow, satisfaction, and miscommunications began in January 2010. Each site
has a six-month wash-in period to implement the RHB intervention before embarking upon an
additional six months of post-intervention data collection. Analysis and dissemination will
begin upon completion of data collection at the last wave of sites in April 2013.
Study Sites:
Children's Hospital Boston (Boston, MA) - Coordinating Site Brigham and Women's Hospital
(Boston, MA) - Data Coordinating Center
Lucile Packard Children's Hospital (Palo Alto, CA) UCSF Benioff Children's Hospital (San
Francisco, CA) OHSU Doernbecher Children's Hospital (Portland, OR) Primary Children's
Medical Center (Salt Lake City, UT) St. Louis Children's Hospital (St. Louis, MO) Cincinnati
Children's Hospital Medical Center (Cincinnati, OH) Hospital for Sick Children (Toronto, ON)
National Capital Consortium (Washington, DC) St. Christopher's Hospital for Children
(Philadelphia, PA)
Study Leadership:
Principal Investigator: Christopher Landrigan, MD, MPH Project Leader: Amy Starmer, MD, MPH
;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Health Services Research