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.
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 Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
84
Informatics tool to aid in transfer of patient care information
Teamwork training and revisions of handoff structure to optimize teamwork skills and verbal communications
Children's Hospital Boston
Boston, Massachusetts, United States
Rates of resident-related communication and total medical errors
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.
Time frame: July 2010
Rates of total medical errors
As above, but includes both those errors involving residents and those involving all other clinical personnel.
Time frame: July 2010
Minutes residents spend updating the signout; minutes spent in direct patient care; minutes spent working at computer
Time frame: July 2010
Resident reported experience of care
Self-reported, Likert scales on survey instruments.
Time frame: July 2010
Rates of verbal miscommunications
Detected by direct observation, audio recording, then rating using study instrument developed for this purpose.
Time frame: July 2010
Rates of written miscommunications
Detected by detailed review of written signouts, rated using study instrument developed for this purpose.
Time frame: July 2010
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