Implementing a Comprehensive Handoff Program to Improve Pediatric Patient Safety

Patient Safety Clinical Trial

Official title:

Implementing a Comprehensive Handoff Program to Improve Pediatric Patient Safety

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01134419
• Other study ID #: X09-01-0040
• Status: Completed
• Phase: N/A
• First received: May 25, 2010
• Last updated: May 15, 2013
• Start date: July 2009
• Est. completion date: January 2010

Study information

• Verified date: May 2013
• Source: Children's Hospital Boston
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

The investigators propose to test the hypothesis that implementation of a comprehensive handoff program (CHP) - i.e., implementation of a computerized handoff tool along with teamwork training for pediatric residents on inpatient units at Children's Hospital Boston - will lead to reductions in resident miscommunications / medical errors and improvements in workflow and experience on the wards.

Description:

Following collection of baseline data on two inpatient pediatric wards, teamwork training is to be provided to all pediatric residents. On our primary intervention unit, this will be accompanied by the introduction of a new computerized handoff tool that facilitates accurate transmission of data. The effects of this combined intervention on safety and workflow will be assessed on the primary intervention ward as compared with the historical control unit and the concurrent unit that received teamwork training without the computerized tool.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 84
• Est. completion date: January 2010
• Est. primary completion date: January 2010
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Both
• Age group: 18 Years to 60 Years

Eligibility

Inclusion Criteria:

• all residents working on study units during study period, except as below

Exclusion Criteria:

• residents on the teamwork only unit who have previously been on the primary intervention unit

Study Design

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research

Related Conditions & MeSH terms

• Patient Safety
• Resident Experience
• Resident Workflow

Intervention

Other:
• Computerized handoff tool
Informatics tool to aid in transfer of patient care information
• Team training
Teamwork training and revisions of handoff structure to optimize teamwork skills and verbal communications

Locations

Country	Name	City	State
United States	Children's Hospital Boston	Boston	Massachusetts

Sponsors (2)

Lead Sponsor	Collaborator
Children's Hospital Boston	Harvard Risk Management Foundation

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Rates of resident-related communication and total medical errors	Resident-related medical errors (including medication-related, diagnostic, and procedural) detected using a multi-pronged prospective surveillance methodology that involves 5d/week chart review, review of hospital incident reports, and collection of staff reports. Resident-related defined as involving a resident research subject. Communication errors are those medical errors attributable to communication failures.	July 2010	Yes
Secondary	Rates of total medical errors	As above, but includes both those errors involving residents and those involving all other clinical personnel.	July 2010	Yes
Secondary	Minutes residents spend updating the signout; minutes spent in direct patient care; minutes spent working at computer		July 2010	No
Secondary	Resident reported experience of care	Self-reported, Likert scales on survey instruments.	July 2010	No
Secondary	Rates of verbal miscommunications	Detected by direct observation, audio recording, then rating using study instrument developed for this purpose.	July 2010	Yes
Secondary	Rates of written miscommunications	Detected by detailed review of written signouts, rated using study instrument developed for this purpose.	July 2010	Yes