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Resident Experiences With Implementation of the I-PASS Handoff Bundle
Journal article   Open access   Peer reviewed

Resident Experiences With Implementation of the I-PASS Handoff Bundle

Maitreya Coffey, Kelly Thomson, Shelly-Anne Li, Zia Bismilla, Amy J. Starmer, Jennifer K. O'Toole, Rebecca L. Blankenburg, Glenn Rosenbluth, F. Sessions Cole, Clifton E. Yu, …
Journal of graduate medical education, v 9(3)
01 Jun 2017
DOI: https://doi.org/10.4300/JGME-D-16-00616.1
PMID: 28638509
url
https://doi.org/10.4300/jgme-d-16-00616.1View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open
url
https://doi.org/10.4300/JGME-D-16-00616.1View
Published, Version of Record (VoR) Open

Abstract

ABSTRACT Background The I-PASS Handoff Study found that introduction of a handoff bundle (handoff and teamwork training for residents, a mnemonic, a handoff tool, a faculty development program, and a sustainability campaign) at 9 pediatrics residency programs was associated with improved communication and patient safety. Objective This parallel qualitative study aimed to understand resident experiences with I-PASS and to inform future implementation and sustainability strategies. Methods Resident experiences with I-PASS were explored in focus groups (N = 50 residents) at 8 hospitals throughout 2012–2013. A content analysis of transcripts was conducted following the principles of grounded theory. Results Residents generally accepted I-PASS as an ideal format for handoffs, and valued learning a structured approach. Across all sites, residents reported full adherence to I-PASS when observed, but selective adherence in usual practice. Residents adhered more closely when patients were complex, teams were unfamiliar, and during evening handoff. Residents reported using elements of the I-PASS mnemonic variably, with Illness Severity and Action Items most consistently used, but Synthesis by Receiver least used, except when observed. Most residents were receptive to the electronic handoff tool, but perceptions about usability varied across sites. Experiences with observation and feedback were mixed. Concern about efficiency commonly influenced attitudes about I-PASS. Conclusions Residents generally supported I-PASS implementation, but adherence was influenced by patient type, context, and individual and team factors. Our findings could inform future implementation, particularly around the areas of resident engagement in change, sensitivity to resident level, perceived efficiency, and faculty observation.

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18 citations in Scopus

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