Resident Experiences With Implementation of the I-PASS Handoff Bundle

Area of Science:

• Medical Education
• Patient Safety
• Qualitative Research

Background:

• The I-PASS Handoff Study introduced a bundle of interventions to improve communication and patient safety in pediatric residency programs.
• These interventions included teamwork training, a mnemonic, a handoff tool, faculty development, and a sustainability campaign.

Purpose of the Study:

• To qualitatively explore resident experiences with the I-PASS handoff bundle.
• To identify factors influencing adherence and inform future implementation and sustainability strategies.

Main Methods:

• Qualitative study involving focus groups with 50 residents across 8 hospitals (2012-2013).
• Content analysis of transcripts using grounded theory principles.

Main Results:

• Residents viewed I-PASS favorably as a structured approach, with high adherence during observation but selective adherence in practice.
• Adherence was higher for complex patients, unfamiliar teams, and evening handoffs.
• Use of the I-PASS mnemonic varied, with 'Illness Severity' and 'Action Items' most consistently applied; 'Synthesis by Receiver' was least used unless observed.

Conclusions:

• Residents generally supported I-PASS, but adherence was context-dependent (patient type, team familiarity, efficiency concerns).
• Findings highlight the need for strategies addressing resident engagement, perceived efficiency, and faculty observation in future implementations.