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Development and Evaluation of I-PASS-to-PICU: A Standard Electronic Template to Improve Referral Communication for Inter-facility Transfers to the Pediatric Intensive Care Unit
Journal article   Open access   Peer reviewed

Development and Evaluation of I-PASS-to-PICU: A Standard Electronic Template to Improve Referral Communication for Inter-facility Transfers to the Pediatric Intensive Care Unit

Nehal R. Parikh, Leticia S. Francisco, Shilpa C. Balikai, Mitchell A. Luangrath, Heather R. Elmore, Jennifer Erdahl, Aditya Badheka, Madhuradhar Chegondi, Christopher P. Landrigan, Priyadarshini Pennathur, …
Joint Commission journal on quality and patient safety, Vol.50(5), pp.338-347
01/2024
DOI: 10.1016/j.jcjq.2024.01.010
PMCID: PMC12917881
PMID: 38418317
url
https://doi.org/10.1016/j.jcjq.2024.01.010View
Published (Version of record) Open Access

Abstract

Background Miscommunication during interfacility handoffs to a higher level of care can harm critically ill children. Adapting evidence-based handoff interventions to interfacility referral communication may prevent adverse events. Our objective was to develop and evaluate a standard electronic referral template (I-PASS-to-PICU) to improve communication for interfacility pediatric ICU (PICU) transfers. Methods I-PASS-to-PICU was iteratively developed in a single PICU. A core PICU stakeholder group collaboratively designed an electronic health record (EHR)-supported clinical note template by adapting elements from I-PASS, an evidence-based handoff program, to support information exchange between referring clinicians and receiving PICU physicians. I-PASS-to-PICU is a receiver-driven tool used by PICU physicians to guide verbal communication and electronic documentation during PICU transfer calls. The template underwent three cycles of iterative evaluation and redesign informed by individual and group interviews of multidisciplinary PICU staff, usability testing using simulated and actual referral calls, and debriefing with PICU physicians. Results Individual and group interviews with 21 PICU staff members revealed that relevant, accurate, and concise information was needed for adequate admission preparedness. Time constraints and second-hand information transmission were identified as barriers. Usability testing with six receiving PICU physicians using simulated and actual calls revealed good usability on the validated systems usability scale (SUS), with a mean score of 78 (SD 11). Fellows indicated that most fields were relevant and that the template was feasible to use. Conclusions I-PASS-to-PICU was technically feasible, usable, and relevant. We plan to further evaluate its effectiveness in improving information exchange during real-time PICU practice.

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