I-PASS Handoff Curriculum: Core Resident Workshop

Publication ID Published Volume
9311 January 17, 2013 9

Abstract

The Core Resident Workshop is the centerpiece of the I-PASS Curriculum Collection. The workshop features a 2-hour didactic and interactive session devoted to team training in structured communication techniques and to the teaching of a standardized approach to the handoff process, including the integration of oral and written handoff components. Key structured team communication techniques and the I-PASS mnemonic are taught in detail and reinforced with the use of trigger videos and large group discussion. Ideally this 2-hour session is followed by the 1-hour Handoff Simulation Exercises which features small group interactive role plays in which participants gain hands-on experience and practice the I-PASS handoff technique. This workshop is also suitable for a faculty educational retreat.

A detailed article describing the development, implementation, and dissemination of the I-PASS Handoff Curriculum can be found at Academic Medicine 2014; 89(6): 876-884. PMID: 24871238.

Goals of the I-PASS Handoff Curriculum for Residents: 

  • Understand the context of medical errors associated with communication failures
  • Introduce the TeamSTEPPS(TM) model of team training with an emphasis on leadership skills, training strategies, and communication skills in order to optimize team function
  • Learn the global elements of effective verbal and printed handoffs
  • Know the elements of an effective verbal handoff
  • Know the elements of an effective printed handoff document
  • Adopt the I-PASS mnemonic
  • Use high quality patient summaries to convey clinical information concisely and effectively in a handoff
  • Incorporate contingency planning in clinical care, especially in handoffs 

Goals of the I-PASS Handoff Curriculum for Faculty: 

  • Understand the role of a faculty champion in the I-PASS handoff program
  • Learn and be able to use the I-PASS handoff technique 
  • Understand the elements and organization of the Core Resident Workshop and Handoff Simulation Exercises

The I-PASS Handoff Curriculum: Core Resident Workshop is one of six submissions which are part of the I-PASS Handoff Curriculum Collection, created by a group of pediatric educators, health services researchers, and hospitalists to teach a standardized approach to handoffs in inpatient settings. This collection is a comprehensive, evidence-based, and consensus-driven suite of educational materials created for a multi-site study that consists of six major complementary components: 

  1. I-PASS Handoff Curriculum: Core Resident Workshop, a 2-hour didactic and interactive session that teaches I-PASS techniques and concept
  2. I-PASS Handoff Curriculum: Handoff Simulation Exercises, a 1-hour interactive role-play session to allow for practicing of techniques learned in the resident workshop or online module
  3. I-PASS Handoff Curriculum: Online Module, an electronic tool that allows for independent learning and review of I-PASS concepts and techniques
  4. I-PASS Handoff Curriculum: Campaign Toolkit, a collection of materials to ensure adoption and implementation of the I-PASS handoff process and change institutional culture
  5. I-PASS Handoff Curriculum: Faculty Development Resources, a set of resources to educate and train faculty or handoff champions for the implementation of the I-PASS handoff program
  6. I-PASS Handoff Curriculum: Faculty Observation Tools, a series of assessment tools designed to be used by institutions implementing the I-PASS handoff process

The results of the multisite I-PASS Handoff Study are published and available at the New England Journal of Medicine 2014; 371: 1803-1812. PMID: 25372088.

In brief, we found in a detailed review of 10,740 patient admissions that a 23% reduction in medical errors and a 30% reduction in injuries due to medical errors (preventable adverse events) occurred following implementation of the I-PASS Handoff Bundle in 9 academic medical centers. In direct observation of thousands of hours of resident workflow (time motion analysis) before and after implementation of the program, conducting handoffs using the I-PASS method was found to require no more time per handoff, and resident workflow throughout the shift was likewise unchanged, including no change in the amount of time spent at the computer or in direct patient care.

Citation

Spector N, Starner A, Allen A, et al. I-PASS handoff curriculum: core resident workshop. MedEdPORTAL Publications. 2013;9:9311. http://dx.doi.org/10.15766/mep_2374-8265.9311

Educational Objectives

  1. To describe the importance of effective communication in reducing medical errors.
  2. To apply effective team training strategies to improve handoffs. 
  3. To detail the essential content and sequence of effective handoffs.
  4. To practice handoff skills.

Keywords

  • Handoff, Handoff Mnemonic, Inpatient Settings, Handovers, Signout, IPASS

References

  1. "Agency for Healthcare Research and Quality. TeamSTEPPS Curriculum Tools and Materials." http://www.ahrq.gov/. N.p., n.d. Web. 6 Feb 2012. http://teamstepps.ahrq.gov/abouttoolsmaterials.htm. 
  2. Bordage, G. "Prototypes and Semantic Qualifiers: From Past to Present." Medical Education. 41.12 (2007): 1117-21. http://dx.doi.org/10.1111/j.1365-2923.2007.02919.x
  3. Cohen, M.D., and Hilligoss, P.B. "The Published Literature on Handoffs in Hospitals: Deficiencies Identified in an Extensive Review. " Quality and Safety in Health Care. 19.6 (2010): 493-497. http://dx.doi.org/10.1136/qshc.2009.033480
  4. Kaplan, D.M. "Perspective: Whither the Problem List? Organ-Based Documentation and Deficient Synthesis by Medical Trainees." Academic Medicine. 85.10 (2010): 1578-1582. http://dx.doi.org/10.1097/ACM.0b013e3181f06c67
  5. Solomon, B. A., and Felder, R.M. "Index of Learning Styles Questionnaire." North Carolina State University. N.p., 2011. Web. 6 Feb 2012. http://www.engr.ncsu.edu/learningstyles/ilsweb.html. 
  6. Starmer, A.J., Spector, N.D., Srivastava, R., Allen, A.D., Landrigan, C.P., Sectish, T.C. et al. "I-PASS, a Mnemonic to Standardize Verbal Handoffs." Pediatrics. 129.2 (2012): 201-204. http://dx.doi.org/10.1542/peds.2011-2966
  7. Starmer, A.J., Sectish, T.C., Simon, D., and Landrigan, C.P. "Impact of a Resident Handoff Bundle on Medical Error Rates and Written Handoff Miscommunications." Pediatric Academic Societies Annual Meeting. Denver, CO. 2011. 

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ISSN 2374-8265