Family Centered Rounds and I-PASS: A framework for the future

From the 2023 HVPA National Conference

Eduardo Reyes, Doctor of Medicine (Florida State University College of Medicine), Sarah Hicks, Doctor of Medicine, Hongyu Zhang, Doctor of Medicine

Introduction:
Miscommunications are a leading source of medical errors. Harmful medical errors decreased in pediatric academic hospitals following implementation of the I-PASS handoff improvement program. However, implementation at the resident physician level has not been assessed.

Objective:
Our aim was to determine if implementation of resident rotator educational sessions on the I-PASS model during Family Centered Rounds (FCR) on the Inpatient Pediatric Unit at AdventHealth For Children (AHFC) improves patient satisfaction with overall communication with their health care team.

Methods:
We analyzed data from online Press Ganey surveys which are randomly delivered to families of patients admitted to AHFC from July 2022. There are multiple resident team members on the inpatient service including pediatric and family medicine residents. Pediatric residents receive training and IPASS FCR practice during orientation, but family med residents do not receive the same level of training. During the cycle our theory was that adding extra training for outside rotators would improve outcomes. Components of the I-PASS model commonly used during handoff were reintroduced via an in-person educational luncheon at the beginning of every block on the best way of carrying out FCRs. Our aim was achieving a 25% improvement of survey results post- intervention with the long-term goal of contributing to the increased satisfaction with communication.

Results:
Data collection took place between July 2022 to January 2023 with the intervention taking place September 25th, 2022. We separated the data into pre and post intervention cohorts to analyze the impact of our intervention on survey results on satisfaction with communication.

Conclusion:
The positive impact of incorporating extra training for I-PASS components for FCRs, and holding a monthly educational luncheon for the residents was successful and demonstrated improved results post-intervention. Despite the limitations of a small sample size and preferences of individual attending physicians, the improvement in patient and family satisfaction shows a promising role of consistent added educational interventions on resident physician effective use of I-PASS.

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

MAVEN campaign: Free 4 year high value care curriculum online.

Join the Alliance! Membership is free with institutional approval and commitment to improving value in your medical center.

Learn more about HVPA on Health Affairs Blog