From Emails to EMR: Implementing I-PASS Among Inpatient Palliative Care Clinicians at a Comprehensive Cancer Center-A...

Area of Science:

• Healthcare quality improvement
• Palliative care medicine
• Interdisciplinary team communication

Background:

• Effective patient handoffs are critical in inpatient palliative care settings.
• Encrypted email handoffs were replaced with the I-PASS system integrated into the electronic medical record (EMR).
• The goal was 90% I-PASS utilization for hospitalized cancer patients receiving palliative care within six months.

Purpose of the Study:

• To implement and assess the utilization of the I-PASS handoff system in inpatient palliative care.
• To evaluate clinician perceptions of the I-PASS system compared to previous email handoffs.

Main Methods:

• A quality improvement initiative implemented I-PASS using the plan-do-study-act cycle.
• Training was provided to all palliative care clinicians before the October 1, 2021, go-live date.
• Utilization was tracked via EMR audits, and clinician feedback was gathered through pre- and post-implementation anonymous surveys.

Main Results:

• I-PASS utilization exceeded 99% within six months, surpassing the 90% goal.
• Clinicians reported significantly higher accuracy (4.20 vs. 3.53), shorter handoff length (2.1 vs. 4.17), and less time required (1.71 vs. 3.0) with I-PASS compared to email.
• Overall clinician satisfaction with I-PASS was high (mean score 4.69).

Conclusions:

• The I-PASS system achieved full adoption and high clinician endorsement in inpatient palliative care.
• I-PASS proved to be an effective communication tool, significantly improving handoff processes.
• Future work should focus on optimizing usability, including smartphone EMR access and streamlined editing.