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

May 25, 2010
May 15, 2013
July 2009
January 2010   (final data collection date for primary outcome measure)
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.
Same as current
Complete list of historical versions of study NCT01134419 on ClinicalTrials.gov Archive Site
  • 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.
Same as current
Not Provided
Not Provided
 
Implementing a Comprehensive Handoff Program to Improve Pediatric Patient Safety
Implementing a Comprehensive Handoff Program to Improve Pediatric Patient Safety

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.

Interventional
Not Provided
Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
  • Patient Safety
  • Resident Workflow
  • Resident Experience
  • 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
  • Experimental: Computerized Handoff Tool plus training
    Computerized handoff tool implemented together with team training for residents
    Interventions:
    • Other: Computerized handoff tool
    • Other: Team training
  • Active Comparator: Team training only
    No computerized tool
    Intervention: Other: Team training
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
84
January 2010
January 2010   (final data collection date for primary outcome measure)

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
Both
18 Years to 60 Years
Yes
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT01134419
X09-01-0040
No
Christopher Landrigan, Children's Hospital Boston
Children's Hospital Boston
Harvard Risk Management Foundation
Principal Investigator: Christopher P Landrigan, MD, MPH Children's Hospital Boston
Children's Hospital Boston
May 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP