Related Experiment Video
Updated: Feb 5, 2026
06:44
Development of a Novel Task-oriented Rehabilitation Program using a Bimanual Exoskeleton Robotic Hand
Published on: May 20, 2020
7.6K
I-PASS Handoff Program: Use of a Campaign to Effect Transformational Change
Glenn Rosenbluth1, Lauren A Destino2, Amy J Starmer3,4
1Department of Pediatrics, University of California San Francisco, San Francisco, Calif.
Pediatric Quality & Safety
|September 20, 2018
Summary
Implementing the I-PASS handoff bundle successfully reduced medical errors and adverse events. This transformational change in academic medical centers offers a model for future healthcare improvement initiatives.
Area of Science:
- Healthcare quality improvement
- Patient safety initiatives
- Academic medical centers
Background:
- Behavior change in healthcare systems is challenging.
- The I-PASS handoff bundle implementation led to reduced medical errors and adverse events.
- This success serves as a model for transformational change in academic medical settings.
Purpose of the Study:
- To support and enhance the adoption of the I-PASS handoff bundle across nine study sites.
- To facilitate widespread implementation of a standardized patient handoff process.
Main Methods:
- Utilized Kotter's model for transformational change.
- Established urgency with local data and mandates.
- Formed guiding coalitions, communicated a vision via a branded campaign, and empowered action through feedback and system changes.
- Focused on short-term wins and institutionalizing improvements.
Main Results:
- Successful implementation of the I-PASS handoff bundle.
- Achieved significant reductions in medical errors and preventable adverse events.
- The initial study data fueled a national campaign, leading to mentored implementation at over 35 North American academic medical centers.
Conclusions:
- The I-PASS program demonstrates successful transformational change through education and change management.
- Addressing resistance and barriers with a robust campaign is key.
- Academic medicine can leverage change models and campaigns for healthcare improvement.
Related Concept Videos
01:12First Pass Effect
9.4K
Presystemic elimination, or the first-pass effect, is the metabolism of drugs that reduces their effective concentration at the site of action. Apart from the first-pass effect, the systemic bioavailability of the drug is also reduced by other factors, including incomplete absorption or chemical degradation of drugs.
Depending on the route of administration, drugs can be metabolized in the liver, intestine, lungs, and vasculature. Orally administered drugs are first absorbed through the...
Depending on the route of administration, drugs can be metabolized in the liver, intestine, lungs, and vasculature. Orally administered drugs are first absorbed through the...
9.4K
01:33Bacterial Transformation
60.0K
In 1928, bacteriologist Frederick Griffith worked on a vaccine for pneumonia, which is caused by Streptococcus pneumoniae bacteria. Griffith studied two pneumonia strains in mice: one pathogenic and one non-pathogenic. Only the pathogenic strain killed host mice.
Griffith made an unexpected discovery when he killed the pathogenic strain and mixed its remains with the live, non-pathogenic strain. Not only did the mixture kill host mice, but it also contained living pathogenic bacteria that...
Griffith made an unexpected discovery when he killed the pathogenic strain and mixed its remains with the live, non-pathogenic strain. Not only did the mixture kill host mice, but it also contained living pathogenic bacteria that...
60.0K
01:25Single-pass Transmembrane Proteins
6.7K
Integral membrane proteins are tightly associated with the cell membrane and play a crucial role in cell communication, signaling, adhesion, and transport of the molecules. Some integral membrane proteins are present only in the membrane monolayer. For example, the enzyme fatty acid amide hydrolase is present in the cytoplasmic side of the membrane monolayer. In contrast, another type of integral membrane protein, also known as a transmembrane protein, spans across the membrane. Transmembrane...
6.7K
01:50Global Climate Change
28.9K
Throughout its ~4.5 billion year history, the Earth has experienced periods of warming and cooling. However, the current drastic increase in global temperatures is well outside of the Earth’s cyclic norms, and evidence for human-caused global climate change is compelling. Paleoclimatology, the study of ancient climate conditions, provides ample evidence for human-caused global climate change by comparing recent conditions with those in the past.
28.9K
01:20Rates of Change
119
The rate of change is a central concept in mathematics that quantifies how one variable varies in response to another. It serves as a foundational tool in modeling dynamic systems across disciplines such as physics, biology, economics, and engineering. Understanding both average and instantaneous rates of change enables the analysis of behavior in functions that describe real-world phenomena.Average Rate of ChangeFor a function f(x) defined over an interval [x1,x2], the average rate of change...
119
01:17Work Done During Volume Change
5.2K
In mechanics, work is done on an object when the force acting on it displaces the object. In thermodynamics, work done on a system can be estimated when the system's volume changes during any thermodynamic process.
Consider a gas confined to a cylinder fitted with a movable piston at one end. If the gas expands from volume V1 to volume V2, it exerts a force on the piston, such that the piston moves by a distance dr.
The work done by the gas on the piston can be expressed as
Consider a gas confined to a cylinder fitted with a movable piston at one end. If the gas expands from volume V1 to volume V2, it exerts a force on the piston, such that the piston moves by a distance dr.
The work done by the gas on the piston can be expressed as
5.2K