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.
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.
Authors: David R Urbach; Anand Govindarajan; Refik Saskin; Andrew S Wilton; Nancy N Baxter Journal: N Engl J Med Date: 2014-03-13 Impact factor: 91.245
Authors: Amy J Starmer; Nancy D Spector; Rajendu Srivastava; Daniel C West; Glenn Rosenbluth; April D Allen; Elizabeth L Noble; Lisa L Tse; Anuj K Dalal; Carol A Keohane; Stuart R Lipsitz; Jeffrey M Rothschild; Matthew F Wien; Catherine S Yoon; Katherine R Zigmont; Karen M Wilson; Jennifer K O'Toole; Lauren G Solan; Megan Aylor; Zia Bismilla; Maitreya Coffey; Sanjay Mahant; Rebecca L Blankenburg; Lauren A Destino; Jennifer L Everhart; Shilpa J Patel; James F Bale; Jaime B Spackman; Adam T Stevenson; Sharon Calaman; F Sessions Cole; Dorene F Balmer; Jennifer H Hepps; Joseph O Lopreiato; Clifton E Yu; Theodore C Sectish; Christopher P Landrigan Journal: N Engl J Med Date: 2014-11-06 Impact factor: 91.245
Authors: Amy J Starmer; Jennifer K O'Toole; Glenn Rosenbluth; Sharon Calaman; Dorene Balmer; Daniel C West; James F Bale; Clifton E Yu; Elizabeth L Noble; Lisa L Tse; Rajendu Srivastava; Christopher P Landrigan; Theodore C Sectish; Nancy D Spector Journal: Acad Med Date: 2014-06 Impact factor: 6.893
Authors: Amy J Starmer; Theodore C Sectish; Dennis W Simon; Carol Keohane; Maireade E McSweeney; Erica Y Chung; Catherine S Yoon; Stuart R Lipsitz; Ari J Wassner; Marvin B Harper; Christopher P Landrigan Journal: JAMA Date: 2013-12-04 Impact factor: 56.272