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| Name | Class |
|---|---|
| Hospital JP Garrahan | OTHER_GOV |
| Ministry of Public Health, Argentina | OTHER_GOV |
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Introduction: Errors in communication, and during transfers of information and medical responsibility, are frequent and risky. Objectives: Primary: To evaluate the effect of the implementation of the I-PASS® transfer program on the reduction in the frequency of medical attention errors in intensive pediatric therapies in the public hospitals setting. Secondary: 1) Measure the effect of the intervention in increasing the frequency of use of key elements of high quality verbal and written communication during the transfer of patients by health professionals. 2) To explore the effect of the intervention on the culture of patient safety among health professionals who assist pediatric patients in areas of clinical hospitalization. Material and Methods: Design: Staged clinical trial (Stepped Wedge) Duration: 9 months (progressive enrollment of 2 participating units every 2 months). Scope: Pediatric Intensive Care Units Subjects: health professionals involved in transfers in each institution. Intervention: Implementation of a multi-faceted evidence-based transfer package (I-PASS®) that has already been adapted for use in Argentina. The program includes multiple components, including educational training, implementation of a mnemonic verbal and written delivery rule I-PASS®, live observations of transfers to drive continuous improvement of the quality of intervention, through the feedback and a campaign of visual reinforcement materials to ensure sustainability. Events of interest: acceptance of the intervention. Frequency of preventable damages associated with medical care measured with GAPPS® as screening tools. Safety culture survey. Length of the transfer before and after the intervention.
Objectives: Primary: To evaluate the effect of the implementation of the I-PASS® transfer program on the reduction in the frequency of medical attention errors in intensive pediatric therapies in the public hospitals setting. Secondary: 1) Measure the effect of the intervention in increasing the frequency of use of key elements of high quality verbal and written communication during the transfer of patients by health professionals. 2) To explore the effect of the intervention on the culture of patient safety among health professionals who assist pediatric patients in areas of clinical hospitalization. Material and Methods: Design: Staged clinical trial (Stepped Wedge) Duration: 9 months (progressive enrollment of 2 participating units every 2 months). Scope: Pediatric Intensive Care Units Subjects: health professionals involved in transfers in each institution. Intervention: Implementation of a multi-faceted evidence-based transfer package (I-PASS®) that has already been adapted for use in Argentina. The program includes multiple components, including educational training, implementation of a mnemonic verbal and written delivery rule I-PASS®, live observations of transfers to drive continuous improvement of the quality of intervention, through the feedback and a campaign of visual reinforcement materials to ensure sustainability. Events of interest: acceptance of the intervention. Frequency of preventable damages associated with medical care measured with GAPPS® as screening tools. Safety culture survey. Length of the transfer before and after the intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | This arm will receive training in the use of the IPASS package to improve communications during hands off. |
|
| Control | No Intervention | Until randomization this arm will continue running hands offs per usual care. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| IPASS | Behavioral | IPASS is behavioral package to improve transitions of care by providing a framework to hands off. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of preventable damages associated with medical care measured with GAPPS® (Global Assessment of Pediatric Patient Safety) | GAPSS (retrospective chart review procedure to identify adverse events in pediatric hospitalizations) will be used to evaluate frequency of preventable adverse events in both arms | measured monthly along 11 months from 6/1/18 to 4/30/19 |
| Measure | Description | Time Frame |
|---|---|---|
| IPASS usage | Frequency of the use of key elements of IPASS for verbal or oral content quality of a sample of transfers (through a checklist administered by an independent observer) | measured monthly along 11 months from 6/1/18 to 4/30/19 |
| Safety culture of the professionals involved in hands off: survey |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ezequiel Garcia Elorrio, MD | Director. Quality and Safety in Healthcare. IECS | Principal Investigator |
| Luis Landry, MD | Director. Intensive Care Unit. Hospital Pedro Garrahan | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Municipal del Niño de San Justo | San Justo | Buenos Aires | Argentina | |||
| Hospital materno infantil héctor Quintana |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33893213 | Derived | Jorro-Baron F, Suarez-Anzorena I, Burgos-Pratx R, De Maio N, Penazzi M, Rodriguez AP, Rodriguez G, Velardez D, Gibbons L, Abalos S, Lardone S, Gallagher R, Olivieri J, Rodriguez R, Vassallo JC, Landry LM, Garcia-Elorrio E. Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: a stepped-wedge trial. BMJ Qual Saf. 2021 Oct;30(10):782-791. doi: 10.1136/bmjqs-2020-012370. Epub 2021 Apr 23. |
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Stepped Wedge Trial
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Safety culture survey from AHRQ will be administered to participants |
| At month 1 (June 2018) and at month 11 (April 2019) of data collection period. |
| San Salvador de Jujuy |
| Jujuy Province |
| Argentina |
| Hospital de Niños Dr. Ricardo Gutiérrez | Buenos Aires | Argentina |
| Hospital Pedro de Elizalde | Buenos Aires | Argentina |
| Prof. Dr. Juan P. Garrahan | Buenos Aires | Argentina |