Implementing a Comprehensive Handoff Program to Improve Pediatric Patient Safety

Not Applicable

Completed

• Conditions: Patient Safety; Resident Workflow; Resident Experience
• Interventions: Other: Computerized handoff tool; Other: Team training

• Registration Number: NCT01134419
• Lead Sponsor: Boston Children's Hospital

Brief Summary

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 pediatric residents on inpatient units at Children's Hospital Boston - will lead to reductions in resident miscommunications / medical errors and improvements in workflow and experience on the wards.

Detailed Description

Following collection of baseline data on two inpatient pediatric wards, teamwork training is to be provided to all pediatric residents. On our primary intervention unit, this will be 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 primary intervention ward as compared with the historical control unit and the concurrent unit that received teamwork training without the computerized tool.

Study Timeline

• Study Start: 2009-07
• Primary Completion: 2010-01
• Study Completion: 2010-01
• Study First Submitted: 2010-05-25
• Study First Submitted QC: 2010-06-01
• Study First Posted: 2010-06-02
• Status Verified: 2013-05
• Last Update Submitted: 2013-05-15
• Last Update Posted: 2013-05-16

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 84

Inclusion Criteria

• all residents working on study units during study period, except as below

Exclusion Criteria

• residents on the teamwork only unit who have previously been on the primary intervention unit

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Computerized Handoff Tool plus training	Computerized handoff tool	Computerized handoff tool implemented together with team training for residents
Computerized Handoff Tool plus training	Team training	Computerized handoff tool implemented together with team training for residents
Team training only	Team training	No computerized tool

Primary Outcome Measures

Name	Time	Method
Rates of resident-related communication and total medical errors	July 2010	Resident-related medical errors (including medication-related, diagnostic, and procedural) detected using a multi-pronged prospective surveillance methodology that involves 5d/week chart review, review of hospital incident reports, and collection of staff reports. Resident-related defined as involving a resident research subject. Communication errors are those medical errors attributable to communication failures.

Secondary Outcome Measures

Name	Time	Method
Rates of total medical errors	July 2010	As above, but includes both those errors involving residents and those involving all other clinical personnel.
Minutes residents spend updating the signout; minutes spent in direct patient care; minutes spent working at computer	July 2010
Resident reported experience of care	July 2010	Self-reported, Likert scales on survey instruments.
Rates of verbal miscommunications	July 2010	Detected by direct observation, audio recording, then rating using study instrument developed for this purpose.
Rates of written miscommunications	July 2010	Detected by detailed review of written signouts, rated using study instrument developed for this purpose.

Trial Locations

Locations (1)

Children's Hospital Boston; 🇺🇸 Boston, Massachusetts, United States