I-CATCH: A Novel Bundle to Improve Postcall Morning Handoffs

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Quality Improvement

Background:

• Morning resident handoffs are crucial for patient care continuity but can be challenging.
• Ineffective handoffs may delay recognition and management of overnight patient issues.
• Standardized handoff bundles aim to improve communication and patient safety.

Purpose of the Study:

• To develop and implement the I-CATCH morning handoff bundle.
• To evaluate the impact of the I-CATCH bundle on the proportion of overnight patient issues handed off.
• To assess the effectiveness of a structured communication tool in resident handoffs.

Main Methods:

• The I-CATCH (Identify patient; Characterize situation; Action-what was done overnight?; To do for the team in the morning; Confirm the Handoff) bundle was implemented on general internal medicine wards.
• Intervention included staff/resident training, structured communication, and dedicated handoff time/space.
• Handoffs were compared pre- and post-implementation using statistical process control for adherence.

Main Results:

• A total of 435 handoffs were observed (242 pre-, 193 post-implementation).
• No significant association was found between I-CATCH implementation and the proportion of overnight issues handed off (OR = 0.96).
• Specific practices like reviewing patients individually, progress note documentation, and direct handoff correlated with increased likelihood of morning handoff.

Conclusions:

• The I-CATCH bundle implementation did not significantly improve the handoff of overnight patient issues.
• While the bundle itself was not effective, certain components of effective handoffs were identified.
• Further research may be needed to optimize resident handoff processes for improved patient care.