O3292: Implementing IPASS Handoff to Improve Patient Safety in Pediatric Critical Care Transport

Background: Ineffective or incomplete handoff between staff negatively impacts patient safety. The aim of this project was to implement a standardized, hospital-based bedside handoff report (IPASS [Illness severity, Patient summary, Action items, Situational awareness, and Synthesis]) in prehospital pediatric critical care transport to increase patient safety by minimizing the risk of misreporting or omitting critical patient care information received before arrival at a tertiary care center.

Methods: The setting for this project was a level 1 pediatric trauma center in the Southern United States with a dedicated, hospital-based inter-facility transport team. The team is composed of a registered nurse (RN) and respiratory therapist (RT), with medical control provided by a pediatric critical care attending physician. Patients transported to the emergency department (ED) are primarily trauma patients or patients requiring emergent surgical intervention necessitating succinct, comprehensive, and structured communication. Transport team members (RN/RT team) and ED staff (attending physicians, fellows, APRNs and nurses) completed an anonymous pre-intervention survey assessing perceptions of the comprehensiveness and individual satisfaction of handoff from the transport team to the emergency department. Each individual then completed an online education module on the IPASS handoff. Following a two-month implementation period, the same providers completed a post-intervention survey. Survey items were compared using Mann-Whitney U test.

Results: 39 providers completed the pre-intervention survey, and 22 completed the post-intervention survey. The responses represented a group of providers with varied roles, training, and experience. Improvement was identified in 6 of 8 survey items. Team members were better able to hear all information provided in the handoff, the format was functional, and physical transfers of patients from the transport team to the ED went more smoothly. Overall satisfaction with the handoff process increased by 80%.

Conclusion: Many factors contribute to patient safety events and errors in healthcare, with communication failures contributing to the majority. The use of a standardized IPASS handoff in pediatric inter-facility critical care transport promotes patient safety, increases comprehension of patient information, and enhances staff satisfaction.