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ABSTRACT: Background
Conducting postcall morning handoffs using a resident handoff bundle such as I-PASS can prove challenging. This may delay recognizing and acting on clinically important patient issues that arose overnight.Objective
We developed and implemented the I-CATCH morning handoff bundle and evaluated its impact on the proportion of overnight patient issues handed off from the on-call resident to the daytime team.Methods
We evaluated the I-CATCH (Identify patient; Characterize situation; Action-what was done overnight?; To do for the team in the morning; Confirm the Handoff) handoff bundle from November 2015 to May 2016 on general internal medicine wards at 1 academic teaching hospital. The bundle entailed staff/resident training, structured communication, and dedicated handoff space and time. We compared handoffs of overnight on-call issues by evening resident to daytime medical team before and after implementation, and used statistical process control to analyze adherence to the mnemonic.Results
We observed 435 handoffs (242 pre- and 193 postimplementation) over 63 days. There was no significant association between I-CATCH implementation and proportion of on-call overnight issues handed off (OR = 0.96; 95% confidence interval [CI] 0.52-1.47; P = .85). Running the list by going through patients one-by-one (OR = 1.74; 95% CI 1.1-2.77; P = .019), progress note documentation (OR = 3.80; 95% CI 2.19-6.60; P < .001), and direct handoff (OR = 4.84; 95% CI 1.43-16.42; P = .011) correlated with an increased likelihood of morning handoff.Conclusions
Implementing the I-CATCH bundle did not improve handoff of overnight issues to the daytime team.
SUBMITTER: Zipursky JS
PROVIDER: S-EPMC6314354 | biostudies-literature | 2018 Dec
REPOSITORIES: biostudies-literature
Zipursky Jonathan S JS Dhhar Gousia G Weinerman Adina A Stroud Lynfa L Wong Brian M BM
Journal of graduate medical education 20181201 6
<h4>Background</h4>Conducting postcall morning handoffs using a resident handoff bundle such as I-PASS can prove challenging. This may delay recognizing and acting on clinically important patient issues that arose overnight.<h4>Objective</h4>We developed and implemented the I-CATCH morning handoff bundle and evaluated its impact on the proportion of overnight patient issues handed off from the on-call resident to the daytime team.<h4>Methods</h4>We evaluated the I-CATCH (<b>I</b>dentify patient; ...[more]