Pragmatic Study: Resident Verbal Handoffs Using I-PASS Reduces Adverse Patient Events During Transitions of Care

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Medical Education

Background:

• Transitions of care between resident teams are high-risk periods for hospitalized patients.
• These vulnerable times can lead to increased adverse patient outcomes.
• Effective communication during handoffs is crucial for patient safety.

Purpose of the Study:

• To evaluate a pragmatic, time-efficient intervention to decrease adverse patient outcomes.
• To assess the impact of a structured verbal handoff using the I-PASS system.
• To compare outcomes between unstructured written and structured verbal handoffs.

Main Methods:

• Prospective study comparing unstructured written handoffs (control) with structured verbal I-PASS handoffs (intervention).
• Intervention included a brief teaching session on I-PASS.
• Adverse events (discharge delays, procedure delays, communication failures, major adverse events) were collected over 21 months.

Main Results:

• The intervention group (I-PASS) showed a significantly lower incidence of the composite endpoint (3.61%) compared to the control group (6.35%).
• This represents an absolute risk reduction of 2.74% (95% CI, 1.3-4.1).
• The number needed to treat was 37 (95% CI, 24-75).

Conclusions:

• A time-efficient, structured verbal I-PASS handoff system effectively reduces adverse patient outcomes.
• Structured handoffs improve patient safety during resident team transitions.
• The I-PASS system offers a pragmatic approach to enhance care coordination.