{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:27:43Z","timestamp":1790980063554,"version":"4.1.0"},"reference-count":44,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Qual Saf"],"accepted":{"date-parts":[[2017,4,23]]},"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background and objective<\/jats:title>\n                  <jats:p>Handoff communication errors are a leading source of sentinel events. We sought to determine the impact of a handoff improvement programme for nurses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a prospective pre-post intervention study on a paediatric intensive care unit in 2011\u20132012. The I-PASS Nursing Handoff Bundle intervention consisted of educational training, verbal handoff I-PASS mnemonic implementation, and visual materials to provide reinforcement and sustainability. We developed handoff direct observation and time motion workflow assessment tools to measure: (1) quality of the verbal handoff, including interruption frequency and presence of key handoff data elements; and (2) duration of handoff and other workflow activities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>I-PASS implementation was associated with improvements in verbal handoff communications, including inclusion of illness severity assessment (37% preintervention vs 67% postintervention, p=0.001), patient summary (81% vs 95%, p=0.05), to do list (35% vs 100%, p&lt;0.001) and an opportunity for the receiving nurse to ask questions (34% vs 73%, p&lt;0.001). Overall, 13\/21 (62%) of verbal handoff data elements were more likely to be present following implementation whereas no data elements were less likely present. Implementation was associated with a decrease in interruption frequency pre versus post intervention (67% vs 40% of handoffs with interruptions, p=0.005) without a change in the median handoff duration (18.8\u2009min vs 19.9\u2009min, p=0.48) or changes in time spent in direct or indirect patient care activities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Implementation of the I-PASS Nursing Handoff Bundle was associated with widespread improvements in the verbal handoff process without a negative impact on nursing workflow. Implementation of I-PASS for nurses may therefore have the potential to significantly reduce medical errors and improve patient safety.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjqs-2016-006224","type":"journal-article","created":{"date-parts":[[2017,7,5]],"date-time":"2017-07-05T20:55:22Z","timestamp":1499288122000},"page":"949-957","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":58,"title":["Effects of the I-PASS Nursing Handoff Bundle on communication quality and workflow"],"prefix":"10.1136","volume":"26","author":[{"given":"Amy J","family":"Starmer","sequence":"first","affiliation":[{"name":"Division of General Pediatrics, Department of Medicine, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumiko O","family":"Schnock","sequence":"additional","affiliation":[{"name":"Center for Patient Safety Research and Practice, Division of General Internal Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimee","family":"Lyons","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Boston Children\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"Franciscan Children\u2019s, Brighton, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca S","family":"Hehn","sequence":"additional","affiliation":[{"name":"Center for Patient Safety and Quality Research, Boston Children\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dionne A","family":"Graham","sequence":"additional","affiliation":[{"name":"Center for Patient Safety and Quality Research, Boston Children\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Keohane","sequence":"additional","affiliation":[{"name":"Center for Patient Safety Research and Practice, Division of General Internal Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"CRICO\/Risk Management Foundation of the Harvard Medical Institutions, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P","family":"Landrigan","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics, Department of Medicine, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Center for Patient Safety Research and Practice, Division of General Internal Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,7,5]]},"reference":[{"key":"2025090412571539000_26.12.949.1","unstructured":"Sentinel event statistics data: root causes by event type. http:\/\/www.jointcommission.org\/sentinel_event_statistics\/ (accessed 19 Mar 2014)."},{"key":"2025090412571539000_26.12.949.2","first-page":"563","article-title":"Handoffs causing patient harm: a survey of medical and surgical house staff","volume":"34","author":"Kitch","year":"2008","journal-title":"Jt Comm J Qual Patient Saf"},{"key":"2025090412571539000_26.12.949.3","unstructured":"McKinley A . 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