A new patient safety and medical education initiative that includes integrating the information exchanged during shift hand-offs with the hospital’s electronic medical record system (EMR) has been instituted at Boston Children’s Hospital. Its goal? To drive down errors by standardizing documentation, according to a hospital press release
The new program, which is hoped to reduce errors by 40 percent, according to physicians at the Pediatric Academic Societies, will allow residents to no longer have to retype information and work from data that wasn’t always updated as things changed, standardizing “hand-offs.”
In 2005 the American Association for Justice reported that hospital errors were between the fifth and eighth leading cause of death and in 2004 they caused almost 200,000 deaths, close to twice as many as in 1998, according to a study.
Errors occur for many reasons -- sometimes, negligence, but others, a systemic breakdown. Your chances of dying in a plane crash are 1 in 8 million, but in a hospital, it’s one in a thousand. A Veterans Health Administration Medical Centers study from 2001 to mid-2006 found that one of the leading causes of medical errors was miscommunication. And national data suggest that up to 70 percent of the most serious errors in hospitals stem at least in part from miscommunications, including those during hand-offs.
The initiative, called I-PASS, has been developed to get around this. Initiated at Boston Children’s Hospital, it’s currently being used and tested in 10 pediatric training programs across North America, including the residency training program at Boston Children’s.
The mission of the I-PASS curriculum, which will now be shared nationally and internationally, is to ensure that incoming doctors are thoroughly and accurately briefed on each patient’s medical history, status and treatment plan.
I-PASS includes team training for clinicians in communication and teamwork skills; an easy-to-remember mnemonic to ensure that key information is imparted in each hand-off; creation of a printed hand-off document that can be integrated into the patient’s EMR record; and direct, structured observation of handoffs by senior physicians, with feedback.
Edited by
Jamie Epstein
