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Alert hand off san diego jan 16

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Alert hand off san diego jan 16

  1. 1. ALERT PRESENTATION: IMPROVING THE QUALITY OF EMERGENT HAND-OFFS USING SIMULATED CRITICAL PATIENT EVENTS AND SIMULATED STRUCTURED EMERGENT HAND-OFFS INSPIRE MEETING, IMSH JAN 28,2012 Ashley Sens, Derek Callaway, Marcy Singleton, Heather Robertson, Matthew Braga
  2. 2. BACKGROUND• Patient hand-offs have been shown to be a portal for failures and medical errors• Developing validated emergent hand-off score tool and emergent hand-off curriculum and demonstrate improved simulated patient hand-offs • Small pilot study to validate an ISBAR based hand-off scoring tool without inter-rater reliability • Ongoing revisions of scoring tool including “splitter” and “lumper” varieties• Knowledge Gaps • Can we develop a general scoring tool for simulated patient handoffs that has inter-rater and intra-rater reliability? • Will a hand-off curriculum improve simulated patient hand-offs? • Can these results be translated to actual patient hand-offs?
  3. 3. PICO QUESTION• Population  Pediatric residents participating in simulated critical patient events, with team leader handing-off the patient at the end of the event.• Intervention  Emergent hand-off curriculum• Comparison  Pre and post curriculum  Curriculum verses no curriculum• Outcome  Statistically significant improvement in hand-off as measured by scoring tool
  4. 4. APPROACH• Prospective cohort study: cohort will be all pediatric residents at Dartmouth- Hitchcock Medical Center with the potential to expand the cohort to be multi- institutional• Validation of a newly developed emergent hand-off score tool• Develop and implement emergent hand-off curriculum using ISBAR format to residents and provide ongoing feedback at the end of each session• Conduct critical event simulations followed by simulated emergent hand -offs• Score emergent hand-offs using newly developed emergent hand-off tool for both pre- and post-exposure to emergent hand-off curriculum
  5. 5. 3 QUESTIONS1 Are others having their team leaders hand-off the patient at the end of a typical resident scenario? How is the hand-off portion evaluated and is feedback given on the patient hand-off?2 What is the best approach to improved inter-rater and intra-rater reliability when developing an emergent hand-off score tool?3 Do we need to develop a specific scripted scenario or can we validate a generalizable hand-off scoring tool?

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