Implementing a Comprehensive Handoff Program to Improve Patient Safety

Study Overview
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Brief Summary
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The investigators propose to test the hypothesis that implementation of a comprehensive handoff program (CHP) - i.e., implementation of a computerized handoff tool along with teamwork training for internal medicine residents on inpatient units at Walter Reed and Madigan Army Medical Centers - will lead to reductions in resident miscommunications / medical errors and improvements in workflow and experience on the wards.

Detailed Description
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Following collection of baseline data on inpatient wards at both hospitals, teamwork training will be provided, accompanied by the introduction of a new computerized handoff tool that facilitates accurate transmission of data. The effects of this combined intervention on safety and workflow will be assessed on the intervention wards at both hospitals as compared with the historical control period.

Official Title
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Implementing a Comprehensive Handoff Program to Improve Patient Safety

Conditions
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Medical Errors

Intervention / Treatment
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* Other: Computerized handoff tool
* Behavioral: Team training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all internal medicine residents completing rotations through intervention units during data collection periods Exclusion Criteria: none

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Comprehensive Handoff Program<br>Introduction of Computerized tool plus team training | Other: Computerized handoff tool<br>* Computer program that facilitates accurate transmission of patient information between residents<br>Behavioral: Team training<br>* Training in teamwork and reorganization of handoff processes to optimize transmission of information and team care<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rates of resident communication and total medical errors |  | July 2010 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rates of all medical errors |  | July 2010 | 
| Rates of verbal miscommunications |  | July 2010 | 
| Rates of written miscommunications |  | July 2010 | 
| Resident workflow, especially time spent updating the signout; time spent at bedside; time spent at computer |  | July 2010 | 
| Resident care experience |  | July 2010 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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resident, intern, patient safety, medical error, time motion, handoff, sign-out, Resident Workflow, Resident Communications