I-PASS enhances effectiveness and accuracy of hand-off for pediatric general surgery patients

  • Author Footnotes
    1 These authors contributed equally to this work.
    Justyna M Wolinska
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, 555 University Avenue, 1526A Hill Wing, Toronto, ON M5G 1×8, Canada

    Division of General and Thoracic Surgery, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Eveline Lapidus-Krol
    Correspondence
    Corresponding author.
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, 555 University Avenue, 1526A Hill Wing, Toronto, ON M5G 1×8, Canada
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  • Erica M Fallon
    Affiliations
    Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, 555 University Avenue, 1526A Hill Wing, Toronto, ON M5G 1×8, Canada
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  • Yuriy Kolivoshka
    Affiliations
    Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, 555 University Avenue, 1526A Hill Wing, Toronto, ON M5G 1×8, Canada
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  • Annie Fecteau
    Affiliations
    Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, 555 University Avenue, 1526A Hill Wing, Toronto, ON M5G 1×8, Canada
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  • Author Footnotes
    1 These authors contributed equally to this work.
Published:November 25, 2021DOI:https://doi.org/10.1016/j.jpedsurg.2021.11.015

      Abstract

      Background

      I-PASS is a validated and standardized hand-off protocol shown to reduce medical error and improve hand-off efficiency in the pediatric medical population. Our aim was to evaluate the feasibility, effectiveness, accuracy and resident satisfaction of implementing I-PASS on a pediatric surgery service.

      Methods

      A prospective intervention Quality Improvement (QI approved) study was utilized to evaluate resident written and verbal hand-offs before and after implementation of I-PASS on a pediatric surgery service at a tertiary center. Anonymous surveys were completed by residents following each observation. Results were analyzed using T or Mann-Whitney U Tests and Chi Square.

      Results

      A total of 49 written tools and 50 verbal hand-offs were compared pre-and post I-PASS implementation. With I-PASS, increased written accuracy was observed in the documentation of the patient summary (p < 0.05). Accuracy in the verbal hand-off of illness severity, patient summary, contingency plan, action list and synthesis also improved (p < 0.05); but duration of hand-off increased (p < 0.01). Post implementation surveys of residents demonstrated an increased understanding of patient management (p < 0.05).

      Conclusion

      Implementing I-PASS on a pediatric surgery service with modifications catered to surgical patients, improved the effectiveness and accuracy of written and verbal patient hand-offs and increased provider satisfaction and preparedness.

      Level of evidence

      Level II.

      Abbreviations:

      QI (Quality Improvement), EMR (Electronic Medical Record), ACGME (Accreditation Council for Graduate Medical Education), ER (Emergency Room), OR (Operating Room), ICU (Intensive Care Unit), NICU (Neonatal Intensive Care Unit), PICU (Pediatric Intensive Care Unit), MRN (Medical Record Number), TPN (Total Parenteral Nutrition)

      Keywords

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