Clinical trial NCT01796756: Quality Improvement in Handover of General Internal Medicine In-patients
Official title: Quality Improvement in Handover of General Internal Medicine In-patients
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Quality Improvement in Patient Handoff
Keywords: Handover
Handoff
Signout
Quality Improvement
General Internal Medicine
Lead sponsor: University of British Columbia
Sponsor class: OTHER
Collaborators: name: Canadian Medical Protective Association
First posted: 2013-02-22
Enrollment: 1168
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Miscommunication during patient handover can jeopardize patient safety and is the focus of Quality Improvement initiatives by many organizations. It is widely recognized that such miscommunication is preventable using a number of strategies identified in the literature.

Currently, there is no formal handover process of General Internal Medicine in-patients, otherwise known as the Clinical Teaching Unit (CTU) at Vancouver General Hospital, which is a major patient safety concern. This project will implement a formal handover program and evaluate whether there are changes in resident satisfaction with handover, but more importantly, whether the investigators can improve patient outcomes.


Eligibility criteria: Inclusion Criteria:

* Residents, medical students, and patients
* Residents and medical students will be any rotating through General Internal Medicine at Vancouver General Hospital
* Patients will be any admitted to General Internal Medicine and cared for during on-call hours (defined as 18:00 - 07:00)

Exclusion Criteria:

* None for residents and medical students
* Patients who are not being cared for during on-call hours (defined as 18:00 - 07:00)

Primary outcomes:
measure: Proportion of patients handed over to the on-call resident/Clinical Associate (CA)
timeFrame: 5 months
Secondary outcomes:
Other outcomes:
measure: Proportion of patients the resident on-call did not receive information on that would have been useful
timeFrame: 5 months
measure: Frequency of patients transferred to the ICU
timeFrame: 5 months
measure: Frequency of patients referred to the Critical Care Outreach Team
timeFrame: 5 months
measure: Frequency of inappropriate code blue calls for patients with a "do not resuscitate" order
timeFrame: 5 months
measure: Aggregate length of stay of patients admitted to the Clinical Teaching Unit
timeFrame: 5 months
measure: Aggregate rate of death of patients admitted to the Clinical Teaching Unit
timeFrame: 5 months
measure: Resource Utilization for patients assessed by the resident on-call overnight
timeFrame: 5 months
Locations:
city: Vancouver
country: Canada
facility: Vancouver General Hospital
state: British Columbia
Study officials:
affiliation: Vancouver General Hospital
name: Penny Tam, BSc, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Tam P, Nijjar AP, Fok M, Little C, Shingina A, Bittman J, Raghavan R, Khan NA. Structured patient handoff on an internal medicine ward: A cluster randomized control trial. PLoS One. 2018 Apr 19;13(4):e0195216. doi: 10.1371/journal.pone.0195216. eCollection 2018.