Related Experiment Video
Updated: Feb 26, 2026
09:52
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
18.0K
Improving Structured Handoff Documentation in a Pediatric Emergency Department
Deborah Hammett1,2, Rebecca Matta3, Jody Kieffer1,2
1From the Division of Emergency Medicine, Nemours Children's Health, Wilmington, Del.
Pediatric Quality & Safety
|February 25, 2026
Summary
Implementing a standardized note template significantly improved provider adherence to the I-PASS handoff tool in a pediatric emergency department, enhancing patient care transitions.
Area of Science:
- Medical Informatics
- Patient Safety
- Pediatric Emergency Medicine
Background:
- Transitions of care are frequent in emergency departments (EDs), where unpredictable environments can compromise structured handoffs.
- The I-PASS handoff tool is designed to guide provider communication and reduce adverse events during patient transfers.
- Existing challenges in EDs necessitate improved methods for structured provider handoffs.
Purpose of the Study:
- To increase the percentage of handoff notes containing all four components of the I-PASS tool by 20% within six months.
- To implement and evaluate a standardized handoff note template in a pediatric ED setting.
- To improve the quality and completeness of provider handoffs during critical care transitions.
Main Methods:
- A handoff note template incorporating the four key I-PASS elements (illness severity, patient care summary, action list, situational awareness/contingency planning) was developed for a pediatric ED.
- A preimplementation (August 2021-July 2022) and postimplementation (August 2022-January 2024) study design was used, analyzing 20 charts monthly.
- Plan-Do-Study-Act cycles were employed for iterative process improvements, including template modification and EMR integration.
Main Results:
- Postimplementation, 63.0% of handoff notes included all four I-PASS elements, a significant increase from 0% preimplementation.
- The utilization of the standardized handoff note template rose to 82.0% from 0% before the intervention.
- No significant change was observed in the rate of handoffs occurring without documentation, indicating the intervention focused on note quality.
Conclusions:
- A standardized note template effectively enhanced adherence to the I-PASS handoff tool within the pediatric ED.
- The intervention demonstrated a successful strategy for improving structured provider handoffs in a high-acuity setting.
- Standardized tools are crucial for optimizing communication and patient safety during care transitions in emergency medicine.
Related Concept Videos
01:29SBAR I: Understanding the Concept
6.2K
Effective communication among healthcare professionals during hand-off reporting is essential to delivering safe and continuous patient care. Common professional interactions include reports to healthcare team members, hand-off, and transfer reports. Nurses routinely report information to other healthcare team members and also urgently contact healthcare providers to report changes in patient status.
Standardized methods of communication have been developed to ensure that information is...
Standardized methods of communication have been developed to ensure that information is...
6.2K
01:25Types of Reports I: Hands-off Report
1.6K
A hand-off report, also known as a change-of-shift report, is a crucial nursing process that ensures the smooth transition of patient care responsibilities between nursing staff.
Following are the key components and categories of hand-off reports:
Purpose and Process:
Following are the key components and categories of hand-off reports:
Purpose and Process:
1.6K
01:17Flow Sheet
2.9K
Flowsheets are valuable tools in nursing documentation. They enable healthcare professionals to efficiently record and monitor various patient assessments and measurements in a consolidated format.
Here's a closer look at the examples of flowsheets commonly used by nurses:
Graphic Sheet Documentation:
Here's a closer look at the examples of flowsheets commonly used by nurses:
Graphic Sheet Documentation:
2.9K
01:29Documentation in Long-Term and Home Healthcare Setting
1.6K
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
1.6K
01:15Methods of Documentation VI: Case Management Model
979
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
979
01:21Methods of Documentation III: PIE
2.1K
Problem-intervention-evaluation (PIE) is a systematic approach to documentation used in healthcare settings for clinical decision-making and patient care planning. It is a structured approach to organizing patient data based on problems, interventions, and evaluations. Here's a breakdown of its key features and considerations:
2.1K