title: Development, implementation, and dissemination of the I-PASS handoff curriculum: A multisite educational intervention to improve patient handoffs.
abstract: Patient handoffs are a key source of communication failures and adverse events in hospitals. Despite Accreditation Council for Graduate Medical Education requirements for residency training programs to provide formal handoff skills training and to monitor handoffs, well-established curricula and validated skills assessment tools are lacking. Developing a handoff curriculum is challenging because of the need for standardized processes and faculty development, cultural resistance to change, and diverse institution- and unit-level factors. In this article, the authors apply a logic model to describe the process they used from June 2010 to February 2014 to develop, implement, and disseminate an innovative, comprehensive handoff curriculum in pediatric residency training programs as a fundamental component of the multicenter Initiative for Innovation in Pediatric Education-Pediatric Research in Inpatient Settings Accelerating Safe Sign-outs (I-PASS) Study. They describe resources, activities, and outputs, and report preliminary learner outcomes using data from resident and faculty evaluations of the I-PASS Handoff Curriculum: 96% of residents and 97% of faculty agreed or strongly agreed that the curriculum promoted acquisition of relevant skills for patient care activities. They also share lessons learned that could be of value to others seeking to adopt a structured handoff curriculum or to develop large-scale curricular innovations that involve redesigning firmly established processes. These lessons include the importance of approaching curricular implementation as a transformational change effort, assembling a diverse team of junior and senior faculty to provide opportunities for mentoring and professional development, and linking the educational intervention with the direct measurement of patient outcomes.
authors.affiliation: Dr. Starmer is staff physician and lecturer in pediatrics, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts. She is also volunteer affiliate professor, Department of Pediatrics, Oregon Health and Science University (OHSU) and OHSU Doernbecher Children's Hospital, Portland, Oregon. Dr. O'Toole is assistant professor, Departments of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Dr. Rosenbluth is associate professor, Department of Pediatrics, University of California, San Francisco (UCSF), School of Medicine and UCSF Benioff Children's Hospital, San Francisco, California. Dr. Calaman is associate professor, Department of Pediatrics, Drexel University College of Medicine and St. Christopher's Hospital for Children, Philadelphia, Pennsylvania. Dr. Balmer is associate professor, Department of Pediatrics, Baylor College of Medicine, Houston, Texas. Dr. West is professor, Department of Pediatrics, University of California, San Francisco (UCSF), School of Medicine and UCSF Benioff Children's Hospital, San Francisco, California. Dr. Bale is professor, Departments of Pediatrics and Neurology, University of Utah School of Medicine, Intermountain Healthcare, and Primary Children's Hospital, Salt Lake City, Utah. Dr. Yu is associate professor, Uniformed Health Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, Maryland. Ms. Noble is I-PASS Study research coordinator, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. Ms. Tse is I-PASS Study research assistant, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. Dr. Srivastava is associate professor, Department of Pediatrics, University of Utah School of Medicine, Primary Children's Hospital, and Institute for Healthcare Delivery Research, Intermountain Healthcare, Salt Lake City, Utah. Dr. Landrigan is as
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Starmer
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: O'Toole
authors.forename: Glenn
authors.initials: G
authors.lastname: Rosenbluth
authors.forename: Sharon
authors.initials: S
authors.lastname: Calaman
authors.forename: Dorene
authors.initials: D
authors.lastname: Balmer
authors.forename: Daniel C
authors.initials: DC
authors.lastname: West
authors.forename: James F
authors.initials: JF
authors.lastname: Bale
authors.forename: Clifton E
authors.initials: CE
authors.lastname: Yu
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Noble
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Tse
authors.forename: Rajendu
authors.initials: R
authors.lastname: Srivastava
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Landrigan
authors.forename: Theodore C
authors.initials: TC
authors.lastname: Sectish
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Spector
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D017145:Models, Educational; D017146:Models, Organizational; D062209:Patient Handoff; D010372:Pediatrics / Q000193:education*; D015397:Program Evaluation; D014481:United States