SHM Converge Scientific Abstract ePoster Gallery-I-Pass-Based Handoff Pilot in a Safety-Net Hospital: Benefits and Barriers

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This qualitative study examined why a written hospitalist handoff process based on the I-PASS program was moderately used but still viewed positively. Although 79% of hospitalists reported satisfaction after implementation, actual compliance averaged only 45%. To understand this mismatch, researchers interviewed 11 physicians and 2 advanced practice providers in February–March 2022 using interviews and homogeneous focus groups. Transcripts were inductively coded, and coding reliability was high (κ = 0.82).<br /><br />Overall, the handoff quality improvement project increased awareness of handoff practices and encouraged some providers to communicate more consistently. Participants recognized that handoffs are important for patient safety, especially in a large urban safety-net hospital with high patient volume and complex cases. However, many felt the tool itself was burdensome or redundant.<br /><br />Common concerns included:<br />- Handoffs were too detailed for all patients, even when only a few were actively sick.<br />- Chart notes and Epic Chat were often seen as sufficient for many situations.<br />- Completing handoffs felt like “another form of documentation” rather than a useful clinical tool.<br />- Night coverage staff needed stronger buy-in from day teams and formal expectations for use.<br /><br />Participants described an ideal handoff system as standardized, concise, and focused on high-yield information such as anticipatory guidance, watch items, and follow-up needs. Key elements of an effective process included:<br />1. A standardized format<br />2. Buy-in from all care teams<br />3. Education on how to use the tool well<br />4. Clear expectations that handoffs must be completed<br /><br />In short, the study found that while the QI project improved awareness, the handoff tool needed refinement to better balance safety, efficiency, and workflow burden.

Asset Subtitle

Malavika Kapuria

Meta Tag

Author List Adekunle O. Obisesan, Amy Miller, Jasmah Hanna, Malavika Kapuria, Mary Ann K. Hall, Reena Hemrajani, Sarah Wondmeneh

Category Research

Concept Standardized Handoff Process

Concept I-PASS

Concept Standardization

Concept Written Handoff Process

Concept Compliance

Distinguished Non-Finalist

Presenter Organization Emory

Presenting Author Malavika Kapuria

Track Quality Improvement

Keywords

I-PASS

hospitalist handoff

qualitative study

patient safety

handoff compliance

quality improvement

Epic Chat

standardized handoff

workflow burden

anticipatory guidance

Standardized Handoff Process

I-PASS

Standardization

Written Handoff Process

Compliance