Implementing a Comprehensive Handoff Program to Improve Pediatric Patient Safety

This study has been completed.
Sponsor:
Collaborator:
Harvard Risk Management Foundation
Information provided by (Responsible Party):
Christopher Landrigan, Children's Hospital Boston
ClinicalTrials.gov Identifier:
NCT01134419
First received: May 25, 2010
Last updated: May 15, 2013
Last verified: May 2013
  Purpose

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.


Condition Intervention
Patient Safety
Resident Workflow
Resident Experience
Other: Computerized handoff tool
Other: Team training

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
Official Title: Implementing a Comprehensive Handoff Program to Improve Pediatric Patient Safety

Resource links provided by NLM:


Further study details as provided by Children's Hospital Boston:

Primary Outcome Measures:
  • Rates of resident-related communication and total medical errors [ Time Frame: July 2010 ] [ Designated as safety issue: Yes ]
    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:
  • Rates of total medical errors [ Time Frame: July 2010 ] [ Designated as safety issue: Yes ]
    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 [ Time Frame: July 2010 ] [ Designated as safety issue: No ]
  • Resident reported experience of care [ Time Frame: July 2010 ] [ Designated as safety issue: No ]
    Self-reported, Likert scales on survey instruments.

  • Rates of verbal miscommunications [ Time Frame: July 2010 ] [ Designated as safety issue: Yes ]
    Detected by direct observation, audio recording, then rating using study instrument developed for this purpose.

  • Rates of written miscommunications [ Time Frame: July 2010 ] [ Designated as safety issue: Yes ]
    Detected by detailed review of written signouts, rated using study instrument developed for this purpose.


Enrollment: 84
Study Start Date: July 2009
Study Completion Date: January 2010
Primary Completion Date: January 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Computerized Handoff Tool plus training
Computerized handoff tool implemented together with team training for residents
Other: Computerized handoff tool
Informatics tool to aid in transfer of patient care information
Other: Team training
Teamwork training and revisions of handoff structure to optimize teamwork skills and verbal communications
Active Comparator: Team training only
No computerized tool
Other: Team training
Teamwork training and revisions of handoff structure to optimize teamwork skills and verbal communications

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.

  Eligibility

Ages Eligible for Study:   18 Years to 60 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

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
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01134419

Locations
United States, Massachusetts
Children's Hospital Boston
Boston, Massachusetts, United States, 02115
Sponsors and Collaborators
Children's Hospital Boston
Harvard Risk Management Foundation
Investigators
Principal Investigator: Christopher P Landrigan, MD, MPH Children's Hospital Boston
  More Information

No publications provided

Responsible Party: Christopher Landrigan, Research and Fellowship Director, Inpatient Pediatrics Service, Children's Hospital Boston
ClinicalTrials.gov Identifier: NCT01134419     History of Changes
Other Study ID Numbers: X09-01-0040
Study First Received: May 25, 2010
Last Updated: May 15, 2013
Health Authority: United States: Institutional Review Board

Keywords provided by Children's Hospital Boston:
Patient Safety
Medical Errors
Handoff
Sign-out
Resident
Intern
Graduate Medical Education

ClinicalTrials.gov processed this record on September 22, 2014