Standardized Handoffs After Pediatric Residency: Retention of Practices and Perceived Importance

Abstract

The I-PASS Handoff Program is linked to reduced medical errors. The enduring handoff practices of residency graduates trained in I-PASS, and attitudes thereof, are unknown. Our objective was to investigate how often residency graduates use I-PASS or other handoff tools, and perspectives regarding standardized handoffs beyond residency. We performed an exploratory electronic survey of residency graduates from programs who participated in the original I-PASS study. Responses were analyzed using descriptive statistics. Of the 106 respondents, 64/106 (60%) identified as “attendings” and the remainder of respondents were subspeciality fellows. The most common practice setting was the inpatient hospital setting, 42/106 (39%). Regarding handoff use, 61/106 (58%) “rarely” or “never” used standardized handoffs. Of those using handoffs, 13/76 (17%) used I-PASS and 59/76 (78%) used a personal system. Most (95/101, 94%) were unaware of any dedicated handoff training or reported it did not exist for attendings, although 77/106 (73%) endorsed their importance for attendings. Despite rigorous residency training and belief in its importance, over one third of graduates did not use standardized handoffs. System-wide requirements for standardized handoffs may improve communication among all providers including physicians, advanced practice providers, and nurses, and enhance patient safety.