![]() ![]() 12 The Institutional Quality Improvement Review Committee approved this study.įor the intervention, we introduced the I-PASS structure through two 20-minute didactic lectures and on-the-job training sessions in September and November 2019. We conducted an observational study with 29 family medicine residents in a family medicine residency training program at an urban hospital. 6 We hypothesized that a standardized handoff process for resident sign-out would (1) reduce preventable unexpected floor calls, (2) improve residents’ confidence to care for patients overnight through better handoffs, and (3) reduce preventable adverse events. 11 In a 2014 multicenter study, the I-PASS Handoff Bundle implementation was shown to reduce preventable adverse events. 6, 10 The I-PASS mnemonic provides a framework for patient handoff as follows: Illness severity, Patient summary, Action list, Situation awareness and contingency planning, Synthesis by receiver. We selected the I-PASS Handoff Bundle because it is the most validated method for handoffs. Our family medicine residency program did not have a standardized overnight sign-out process. 5 Residency programs in other subspecialties, including pediatrics and internal medicine, have implemented standardized transition-of-care processes for the inpatient setting, although assessment of these quality improvement measures remains ongoing and data from family medicine are lacking. 4 The Accreditation Council for Graduate Medical Education (ACGME) mandates resident training in effective transitions of patient care and emphasizes the importance of managing handoffs to comply with new recommendations for resident duty hours. Patient handoffs between residents have become more frequent because of duty hour restrictions. 2 For example, a 2009 systematic review found that omitted information and incorrect information were common at patient care handoff. 1 Ineffective or incomplete transitions of care can negatively impact both patients and physicians by contributing to potential miscommunication and errors, or by compromising resident confidence. Communication error is a leading cause for sentinel events. ![]()
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