Ethan Gillett, MD
Fellow Physician
University of Arkansas for Medical Sciences Arkansas Childrens Hospital
Little Rock, Arkansas
Disclosure information not submitted.
Franklin Welborn, MD
Physician
Arkansas Children's Hospital, United States
Disclosure information not submitted.
Ronald Sanders, MD, MS, FCCM
Professor of Pediatrics
Arkansas Childrens Hospital, United States
Disclosure information not submitted.
Title: Implementation of Standardized Patient Handoff in Critically Ill Children
Introduction:
Patient handoff from one provider to another is a well-known opportunity for communication failure potentially leading to serious patient harm. This is particularly true of critically ill pediatric patients. We implemented a tool in order to aid safe and effective handoff between providers for patients being admitted to our pediatric ICU through the emergency department.
Methods:
A standardized, systems-based handoff form using a modified I-PASS format was designed from input from several stakeholders and implemented for patients being admitted to the PICU through the ED. The primary outcome was overall provider satisfaction at both the faculty and trainee level using pre and post intervention surveys. Participants were asked to rate their satisfaction with the handoff process on a scale from 1-5, with 1 being extremely unsatisfied and 5 being extremely satisfied. The survey was repeated 6-months after implementation of the handoff tool.
Results:
There were 28 responses to the initial survey from the ED (n=18, 64 %) and the PICU (n=10, 36%) with 21 responses from attendings (75 %) and 7 from fellows (25 %). The average rating was 3.45 (SD 1.05). There were 19 responses to the post-intervention survey from the ED (n=11, 58 %) and the PICU (n=8, 42%) with 11 responses from attendings (58%) and 8 from fellows (42%). The average rating was 3.49 (SD 1.2). There was no statistical significance between overall provider satisfaction following implementation of the handoff tool (p=0.76). Further analysis did not demonstrate a difference in satisfaction at the attending (p=0.15) or fellow (p=0.13) levels.
Conclusion:
There was no difference in provider satisfaction of patient handoff at either the faculty or trainee level after implementing a standardized format. However, compliance with the handoff tool was very poor. We plan to modify the handoff tool based on provider input in order to improve both satisfaction and effectiveness.