I-PASS role-plays are simulation exercises that serve to bring all the I-PASS curricular elements together. The role-plays allow practice with the techniques and include resident and faculty feedback to help learners refine the skills learned and place them in context. Three role-plays involve performing an I-PASS handoff with a giver, receiver, and observer. Communication challenges, such as interruptions, are introduced in later role-plays to increase complexity as learners go through the exercises. The observer uses the faculty observation tools that faculty will subsequently use to evaluate live handoffs. The final role-play focuses on developing a shared mental model. In this exercise, each group of three is divided into a giver and two receivers who develop the action items, as well as the situation awareness and contingency planning portions of the written handoff based on the information from the giver. Neighboring groups perform the same exercise with slightly different information and then compare their success in developing a shared mental model. 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 nine 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.
By the end of the module, the learner will be able to:
- Practice handoff skills.
- Demonstrate the importance of creating a shared mental model.
Drs. Calaman and Hepps are co-primary authors on this publication.
Drs. Landrigan and Srivastava are supported in part by the Child Health Corporation of America for their work on the PRIS Research Network Executive Council. Dr Starmer is supported in part by an institutional K12 award from Oregon Health and Science University and the Agency for Health Care Research and Quality, grant 1K12HS019456-01. This work was developed with input from the IIPE and the PRIS Network.
This educational module was supported by a grant from the US Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation (# 1R18AE000023-01), in addition to an in-kind sponsorship from both the Initiative for Innovation in Pediatric Education (IIPE) and Pediatric Research in Inpatient Settings (PRIS).
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