Long-Term Sustainability and Adaptation of I-PASS Handovers

Area of Science:

• Healthcare Quality and Safety
• Medical Communication
• Health Systems Research

Background:

• Inadequate communication during care transitions is a significant healthcare quality and safety issue.
• Massachusetts General Hospital (MGH) implemented the I-PASS standardized handover system in 2013 to reduce adverse events.
• This study assessed handover practices six years post-implementation.

Purpose of the Study:

• To characterize clinician handover practices six years after hospitalwide implementation of the I-PASS system.
• To evaluate the adherence and effectiveness of the I-PASS system in a real-world clinical setting.
• To compare current handover practices with initial post-intervention data and external benchmarks.

Main Methods:

• A cross-sectional study involving standardized interviews and direct observations of clinicians in 10 departments.
• Evaluation of 156 verbal and 182 written patient handovers.
• Qualitative comparison of I-PASS element use against MGH's early post-intervention data and the I-PASS Study Group's results.

Main Results:

• Ninety percent of departments showed at least partial adherence to the I-PASS system.
• Average handover duration ranged from 0.6 to 2.1 minutes per patient.
• MGH's adherence was comparable or superior to the I-PASS Study Group's results for verbal and written handovers.

Conclusions:

• Six years post-implementation, the majority of services utilize structured handovers incorporating I-PASS elements.
• Adherence to the I-PASS system has varied across different hospital services.
• Services with the highest I-PASS adherence exhibited the most efficient handovers, suggesting a positive impact on communication efficiency.