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Adapting the I-PASS Handoff Program for Emergency Department Inter-Shift Handoffs.

James A Heilman1, Moira Flanigan1, Anna Nelson1

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Modifying the I-PASS handoff system for emergency departments (EDs) can improve patient care transitions. This study suggests adaptations for brevity and clarity, making the I-PASS suitable for ED inter-shift handoffs.

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Area of Science:

  • Medical Education
  • Patient Safety
  • Health Systems Research

Background:

  • Academic emergency department (ED) handoffs are critical yet high-risk patient care transitions.
  • Emergency medicine residents often lack sufficient training for these vital inter-shift handoffs.
  • The I-PASS (illness severity, patient summary, action list, situation awareness and contingency plans, and synthesis by receiver) system is a standardized handoff tool.

Purpose of the Study:

  • To explore necessary modifications of the I-PASS handoff system for effective use in academic ED inter-shift handoffs.
  • To identify distinctive elements of ED handoffs and integrate them into the I-PASS framework.
  • To assess the suitability of the I-PASS system for the ED environment.

Main Methods:

  • A mixed-method needs assessment was conducted in an academic ED.
  • Methods included a literature review, focus groups with healthcare professionals, and a subsequent survey.
  • Qualitative and quantitative data were gathered to identify necessary adaptations.

Main Results:

  • Participants recommended adapting the patient summary to include anticipated patient disposition.
  • The general order and content of the I-PASS tool were endorsed, with suggestions for wording changes for contextual relevance.
  • Convergent themes from qualitative data highlighted the need for brevity and clarity in the ED setting.

Conclusions:

  • The I-PASS system, with modifications for context, brevity, and clarity, appears well-suited for ED inter-shift handoffs.
  • This study provides qualitative support and specific modification suggestions for implementing I-PASS in the ED.
  • Further implementation and outcome research are necessary to evaluate feasibility and impact on patient outcomes.