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| Name | Class |
|---|---|
| Harvard Risk Management Foundation | OTHER |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Computerized Handoff Tool plus training | Experimental | Computerized handoff tool implemented together with team training for residents |
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| Team training only | Active Comparator | No computerized tool |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Computerized handoff tool | Other | Informatics tool to aid in transfer of patient care information |
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| Measure | Description | Time Frame |
|---|---|---|
| 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. | July 2010 |
| Measure | Description | Time Frame |
|---|---|---|
| Rates of total medical errors | As above, but includes both those errors involving residents and those involving all other clinical personnel. | July 2010 |
| Minutes residents spend updating the signout; minutes spent in direct patient care; minutes spent working at computer |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Christopher P Landrigan, MD, MPH | Boston Children's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children's Hospital Boston | Boston | Massachusetts | 02115 | United States |
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| Team training | Other | Teamwork training and revisions of handoff structure to optimize teamwork skills and verbal communications |
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| July 2010 |
| Resident reported experience of care | Self-reported, Likert scales on survey instruments. | July 2010 |
| Rates of verbal miscommunications | Detected by direct observation, audio recording, then rating using study instrument developed for this purpose. | July 2010 |
| Rates of written miscommunications | Detected by detailed review of written signouts, rated using study instrument developed for this purpose. | July 2010 |