I-PASS Handoff Curriculum: Faculty Observation Tools

Publication ID Published Volume
9570 October 3, 2013 9

Abstract

The Faculty Observation Tools section contains a set of assessment tools designed to be used by residency programs implementing the Core Resident Workshop in order to ensure that residents acquire competency in handoff skills, as well as to reinforce the I-PASS techniques and ensure sustainment of the I-PASS Handoff Curriculum. These tools are also meant to meet the ACGME Common Program Requirements that all training programs ensure and monitor effective patient handoffs. Included are tools to assess the skills of the giver and receiver of verbal handoffs, as well as a tool to assess the quality of a printed patient handoff document. In addition, we include detailed information about how to administer and apply each item in the assessment tools, Guidelines for Faculty Observations of Resident Handoffs (Chapter IV in the Faculty Champions Guide from Faculty Development Resources).

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
  • Introduce the faculty observation process for the I-PASS handoff program

The I-PASS Handoff Curriculum: Faculty Observation Tools 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

Citation

Starmer A, Landrigan C, Srivastava R, et al. I-PASS handoff curriculum: faculty observation tools. MedEdPORTAL Publications. 2013;9:9570. http://doi.org/10.15766/mep_2374-8265.9570

Educational Objectives

  1. To list the elements that faculty can observe during a resident to resident handoff.
  2. To explain how immediate feedback can improve the quality of a handoff.
  3. To describe how providing feedback on a printed handoff document can improve the transfer of care and responsibility during a handoff.

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.

Keywords

  • Direct Observations, Handoffs, Patient Handoffs, Verbal Handoffs, Written Handoffs, Handovers, Signout, Faculty Development, Faculty Training, Feedback, IPASS

References

  • Roen MA, Schiebel N, Salas E, Wu T, Salvatore S, King HB. How can team performance be measured, assessed, and diagnosed? In: Improving Patient Safety Through Teamwork and Team Training. Salas E and Frush K (Eds). Oxford University Press, August, 2012.
  • Maughan BC, Lei L, Cydulka RK. ED handoffs: observed practices and communication errors. Am J Emerg Med 2011; 29: 502-11. http://dx.doi.org/10.1016/j.ajem.2009.12.004
  • Apker J, Mallack LA, Applegate EB 3rd, Gibson SC, Ham JJ, Johnson NA, Street RL Jr. Exploring emergenecy physician-hospitalist handoff interactions: development of the handoff communication assessment. Ann Emerg Med 2010; 55: 161-70. http://dx.doi.org/10.1016/j.annemergmed.2009.09.021
  • Hinami K, Farnan JM, Meltzer DO, Arora VM. Understanding communication during hospitalist service changes: a mixed methods study. J Hosp Med 2009; 4: 535-40. http://dx.doi.org/10.1002/jhm.523
  • Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007; 297: 831-41. http://dx.doi.org/10.1001/jama.297.8.831

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