Implementation of the I-PASS handoff to improve provider-to-provider handoff communication

BACKGROUND: Provider handoff communication is essential to the continuity of care and safety of patients. The illness severity, patient information, action list, situational awareness and contingency plans, and synthesis (I-PASS) tool is an evidence-based resource that has been effective in handoffs between providers in a variety of settings. The tool was selected to improve provide communication in efforts to reduce surgical interventions and procedures in a gastroenterology inpatient setting. LOCAL PROBLEM: In an inpatient gastroenterology unit, there was no standardized handoff in place between gastroenterologist and nurse practitioners (NPs). Therefore, there were gaps in patient information, which would further delay procedures. METHODS: Using a plan-do-study-act framework, a quality improvement project was implemented to evaluate the effectiveness of I-PASS handoff implementation among NPs serving in a busy inpatient gastrointestinal setting. INTERVENTION: The standardized I-PASS handoff was implemented between gastroenterologist and NPs in an inpatient gastroenterology setting in an effort to reduce same-day cancellations of gastroenterology procedures. RESULTS: More than half (60%) fully adopted the standardized I-PASS handoff tool. Some seasoned providers resisted adopting a new standardized handoff. Monthly gastroenterology procedural cancellation rates steadily declined after the implementation of the standardized handoff tool. CONCLUSIONS: Standardized provider handoff tools are effective in reducing communication errors and improving health care efficiency. The I-PASS tool is a useful handoff tool for inpatient gastroenterology teams and should be considered for implementation among other health delivery teams that care for complex patients and those that use resources such as a surgical suite or procedural laboratory.