Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trial
- Autores
- Jorro Baron, Facundo Ariel; Suarez Anzorena, Inés; Burgos Pratx, Rodrigo; De Maio, Noelia; Penazzi, Matiás; Rodriguez, Ana Paula; Rodriguez, Gisela; Velardez, Daniel; Gibbons, Luz; Ábalos, Silvina; Lardone, Silvina; Gallagher, Rosario; Olivieri, Joaquín; Rodriguez, Rocío; Vassallo, Juan Carlos; Landry, Luis Martín; Garcia Elorrio, Ezequiel
- Año de publicación
- 2021
- Idioma
- inglés
- Tipo de recurso
- artículo
- Estado
- versión publicada
- Descripción
- Background There are only a few studies on handoff quality and adverse events (AEs) rigorously evaluating handoff improvement programmes' effectiveness. None of them have been conducted in low and middle-income countries. We aimed to evaluate the effect of a handoff programme implementation in reducing AE frequency in paediatric intensive care units (PICUs). Methods Facility-based, cluster-randomised, stepped-wedge trial in six Argentine PICUs in five hospitals, with >20 admissions per month. The study was conducted from July 2018 to May 2019, and all units at least were involved for 3 months in the control period and 4 months in the intervention period. The intervention comprised a Spanish version of the I-PASS handoff bundle consisting of a written and verbal handoff using mnemonics, an introductory workshop with teamwork training, an advertising campaign, simulation exercises, observation and standardised feedback of handoffs. Medical records (MR) were reviewed using trigger tool methodology to identify AEs (primary outcome). Handoff compliance and duration were evaluated by direct observation. Results We reviewed 1465 MRs: 767 in the control period and 698 in the intervention period. We did not observe differences in the rates of preventable AE per 1000 days of hospitalisation (control 60.4 (37.5-97.4) vs intervention 60.4 (33.2-109.9), p=0.99, risk ratio: 1.0 (0.74-1.34)), and no changes in the categories or AE types. We evaluated 841 handoffs: 396 in the control period and 445 in the intervention period. Compliance with all items in the verbal and written handoffs was significantly higher in the intervention group. We observed no difference in the handoff time in both periods (control 35.7 min (29.6-41.8) vs intervention 34.7 min (26.5-42.1); difference 1.43 min (95% CI -2.63 to 5.49, p=0.49)). The providers' perception of improved communication did not change. Conclusions After the implementation of the I-PASS bundle, compliance with handoff items improved. Nevertheless, no differences were observed in the AEs' frequency or the perception of enhanced communication.
Fil: Jorro Baron, Facundo Ariel. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Suarez Anzorena, Inés. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Burgos Pratx, Rodrigo. Gobierno de la Provincia de Jujuy. Hospital Materno Infantil Doctor Hector Quintana; Argentina
Fil: De Maio, Noelia. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Penazzi, Matiás. Municipalidad de la Matanza (Buenos Aires). Hospital Municipal del Niño de San Justo; Argentina
Fil: Rodriguez, Ana Paula. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); Argentina
Fil: Rodriguez, Gisela. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina
Fil: Velardez, Daniel. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Ábalos, Silvina. Gobierno de la Provincia de Jujuy. Hospital Materno Infantil Doctor Hector Quintana; Argentina
Fil: Lardone, Silvina. Municipalidad de la Matanza (Buenos Aires). Hospital Municipal del Niño de San Justo; Argentina
Fil: Gallagher, Rosario. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Olivieri, Joaquín. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina
Fil: Rodriguez, Rocío. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Vassallo, Juan Carlos. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Landry, Luis Martín. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Garcia Elorrio, Ezequiel. Instituto de Efectividad Clínica y Sanitaria; Argentina - Materia
-
ADVERSE EVENTS
CRITICAL CARE
EPIDEMIOLOGY AND DETECTION
HAND-OFF
PAEDIATRICS
QUALITY IMPROVEMENT - Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
- Repositorio
.jpg)
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/165447
Ver los metadatos del registro completo
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Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trialJorro Baron, Facundo ArielSuarez Anzorena, InésBurgos Pratx, RodrigoDe Maio, NoeliaPenazzi, MatiásRodriguez, Ana PaulaRodriguez, GiselaVelardez, DanielGibbons, LuzÁbalos, SilvinaLardone, SilvinaGallagher, RosarioOlivieri, JoaquínRodriguez, RocíoVassallo, Juan CarlosLandry, Luis MartínGarcia Elorrio, EzequielADVERSE EVENTSCRITICAL CAREEPIDEMIOLOGY AND DETECTIONHAND-OFFPAEDIATRICSQUALITY IMPROVEMENThttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background There are only a few studies on handoff quality and adverse events (AEs) rigorously evaluating handoff improvement programmes' effectiveness. None of them have been conducted in low and middle-income countries. We aimed to evaluate the effect of a handoff programme implementation in reducing AE frequency in paediatric intensive care units (PICUs). Methods Facility-based, cluster-randomised, stepped-wedge trial in six Argentine PICUs in five hospitals, with >20 admissions per month. The study was conducted from July 2018 to May 2019, and all units at least were involved for 3 months in the control period and 4 months in the intervention period. The intervention comprised a Spanish version of the I-PASS handoff bundle consisting of a written and verbal handoff using mnemonics, an introductory workshop with teamwork training, an advertising campaign, simulation exercises, observation and standardised feedback of handoffs. Medical records (MR) were reviewed using trigger tool methodology to identify AEs (primary outcome). Handoff compliance and duration were evaluated by direct observation. Results We reviewed 1465 MRs: 767 in the control period and 698 in the intervention period. We did not observe differences in the rates of preventable AE per 1000 days of hospitalisation (control 60.4 (37.5-97.4) vs intervention 60.4 (33.2-109.9), p=0.99, risk ratio: 1.0 (0.74-1.34)), and no changes in the categories or AE types. We evaluated 841 handoffs: 396 in the control period and 445 in the intervention period. Compliance with all items in the verbal and written handoffs was significantly higher in the intervention group. We observed no difference in the handoff time in both periods (control 35.7 min (29.6-41.8) vs intervention 34.7 min (26.5-42.1); difference 1.43 min (95% CI -2.63 to 5.49, p=0.49)). The providers' perception of improved communication did not change. Conclusions After the implementation of the I-PASS bundle, compliance with handoff items improved. Nevertheless, no differences were observed in the AEs' frequency or the perception of enhanced communication.Fil: Jorro Baron, Facundo Ariel. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Suarez Anzorena, Inés. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Burgos Pratx, Rodrigo. Gobierno de la Provincia de Jujuy. Hospital Materno Infantil Doctor Hector Quintana; ArgentinaFil: De Maio, Noelia. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Penazzi, Matiás. Municipalidad de la Matanza (Buenos Aires). Hospital Municipal del Niño de San Justo; ArgentinaFil: Rodriguez, Ana Paula. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); ArgentinaFil: Rodriguez, Gisela. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Velardez, Daniel. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Ábalos, Silvina. Gobierno de la Provincia de Jujuy. Hospital Materno Infantil Doctor Hector Quintana; ArgentinaFil: Lardone, Silvina. Municipalidad de la Matanza (Buenos Aires). Hospital Municipal del Niño de San Justo; ArgentinaFil: Gallagher, Rosario. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Olivieri, Joaquín. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Rodriguez, Rocío. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Vassallo, Juan Carlos. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Landry, Luis Martín. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Garcia Elorrio, Ezequiel. Instituto de Efectividad Clínica y Sanitaria; ArgentinaBMJ Publishing Group2021-10info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/165447Jorro Baron, Facundo Ariel; Suarez Anzorena, Inés; Burgos Pratx, Rodrigo; De Maio, Noelia; Penazzi, Matiás; et al.; Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trial; BMJ Publishing Group; BMJ Quality and Safety; 30; 10; 10-2021; 782-7912044-5415CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1136/bmjqs-2020-012370info:eu-repo/semantics/altIdentifier/url/https://qualitysafety.bmj.com/content/30/10/782info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:09:27Zoai:ri.conicet.gov.ar:11336/165447instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:09:27.91CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse |
| dc.title.none.fl_str_mv |
Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trial |
| title |
Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trial |
| spellingShingle |
Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trial Jorro Baron, Facundo Ariel ADVERSE EVENTS CRITICAL CARE EPIDEMIOLOGY AND DETECTION HAND-OFF PAEDIATRICS QUALITY IMPROVEMENT |
| title_short |
Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trial |
| title_full |
Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trial |
| title_fullStr |
Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trial |
| title_full_unstemmed |
Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trial |
| title_sort |
Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trial |
| dc.creator.none.fl_str_mv |
Jorro Baron, Facundo Ariel Suarez Anzorena, Inés Burgos Pratx, Rodrigo De Maio, Noelia Penazzi, Matiás Rodriguez, Ana Paula Rodriguez, Gisela Velardez, Daniel Gibbons, Luz Ábalos, Silvina Lardone, Silvina Gallagher, Rosario Olivieri, Joaquín Rodriguez, Rocío Vassallo, Juan Carlos Landry, Luis Martín Garcia Elorrio, Ezequiel |
| author |
Jorro Baron, Facundo Ariel |
| author_facet |
Jorro Baron, Facundo Ariel Suarez Anzorena, Inés Burgos Pratx, Rodrigo De Maio, Noelia Penazzi, Matiás Rodriguez, Ana Paula Rodriguez, Gisela Velardez, Daniel Gibbons, Luz Ábalos, Silvina Lardone, Silvina Gallagher, Rosario Olivieri, Joaquín Rodriguez, Rocío Vassallo, Juan Carlos Landry, Luis Martín Garcia Elorrio, Ezequiel |
| author_role |
author |
| author2 |
Suarez Anzorena, Inés Burgos Pratx, Rodrigo De Maio, Noelia Penazzi, Matiás Rodriguez, Ana Paula Rodriguez, Gisela Velardez, Daniel Gibbons, Luz Ábalos, Silvina Lardone, Silvina Gallagher, Rosario Olivieri, Joaquín Rodriguez, Rocío Vassallo, Juan Carlos Landry, Luis Martín Garcia Elorrio, Ezequiel |
| author2_role |
author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
ADVERSE EVENTS CRITICAL CARE EPIDEMIOLOGY AND DETECTION HAND-OFF PAEDIATRICS QUALITY IMPROVEMENT |
| topic |
ADVERSE EVENTS CRITICAL CARE EPIDEMIOLOGY AND DETECTION HAND-OFF PAEDIATRICS QUALITY IMPROVEMENT |
| purl_subject.fl_str_mv |
https://purl.org/becyt/ford/3.3 https://purl.org/becyt/ford/3 |
| dc.description.none.fl_txt_mv |
Background There are only a few studies on handoff quality and adverse events (AEs) rigorously evaluating handoff improvement programmes' effectiveness. None of them have been conducted in low and middle-income countries. We aimed to evaluate the effect of a handoff programme implementation in reducing AE frequency in paediatric intensive care units (PICUs). Methods Facility-based, cluster-randomised, stepped-wedge trial in six Argentine PICUs in five hospitals, with >20 admissions per month. The study was conducted from July 2018 to May 2019, and all units at least were involved for 3 months in the control period and 4 months in the intervention period. The intervention comprised a Spanish version of the I-PASS handoff bundle consisting of a written and verbal handoff using mnemonics, an introductory workshop with teamwork training, an advertising campaign, simulation exercises, observation and standardised feedback of handoffs. Medical records (MR) were reviewed using trigger tool methodology to identify AEs (primary outcome). Handoff compliance and duration were evaluated by direct observation. Results We reviewed 1465 MRs: 767 in the control period and 698 in the intervention period. We did not observe differences in the rates of preventable AE per 1000 days of hospitalisation (control 60.4 (37.5-97.4) vs intervention 60.4 (33.2-109.9), p=0.99, risk ratio: 1.0 (0.74-1.34)), and no changes in the categories or AE types. We evaluated 841 handoffs: 396 in the control period and 445 in the intervention period. Compliance with all items in the verbal and written handoffs was significantly higher in the intervention group. We observed no difference in the handoff time in both periods (control 35.7 min (29.6-41.8) vs intervention 34.7 min (26.5-42.1); difference 1.43 min (95% CI -2.63 to 5.49, p=0.49)). The providers' perception of improved communication did not change. Conclusions After the implementation of the I-PASS bundle, compliance with handoff items improved. Nevertheless, no differences were observed in the AEs' frequency or the perception of enhanced communication. Fil: Jorro Baron, Facundo Ariel. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Suarez Anzorena, Inés. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Burgos Pratx, Rodrigo. Gobierno de la Provincia de Jujuy. Hospital Materno Infantil Doctor Hector Quintana; Argentina Fil: De Maio, Noelia. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina Fil: Penazzi, Matiás. Municipalidad de la Matanza (Buenos Aires). Hospital Municipal del Niño de San Justo; Argentina Fil: Rodriguez, Ana Paula. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); Argentina Fil: Rodriguez, Gisela. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina Fil: Velardez, Daniel. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina Fil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Ábalos, Silvina. Gobierno de la Provincia de Jujuy. Hospital Materno Infantil Doctor Hector Quintana; Argentina Fil: Lardone, Silvina. Municipalidad de la Matanza (Buenos Aires). Hospital Municipal del Niño de San Justo; Argentina Fil: Gallagher, Rosario. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina Fil: Olivieri, Joaquín. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina Fil: Rodriguez, Rocío. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Vassallo, Juan Carlos. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina Fil: Landry, Luis Martín. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina Fil: Garcia Elorrio, Ezequiel. Instituto de Efectividad Clínica y Sanitaria; Argentina |
| description |
Background There are only a few studies on handoff quality and adverse events (AEs) rigorously evaluating handoff improvement programmes' effectiveness. None of them have been conducted in low and middle-income countries. We aimed to evaluate the effect of a handoff programme implementation in reducing AE frequency in paediatric intensive care units (PICUs). Methods Facility-based, cluster-randomised, stepped-wedge trial in six Argentine PICUs in five hospitals, with >20 admissions per month. The study was conducted from July 2018 to May 2019, and all units at least were involved for 3 months in the control period and 4 months in the intervention period. The intervention comprised a Spanish version of the I-PASS handoff bundle consisting of a written and verbal handoff using mnemonics, an introductory workshop with teamwork training, an advertising campaign, simulation exercises, observation and standardised feedback of handoffs. Medical records (MR) were reviewed using trigger tool methodology to identify AEs (primary outcome). Handoff compliance and duration were evaluated by direct observation. Results We reviewed 1465 MRs: 767 in the control period and 698 in the intervention period. We did not observe differences in the rates of preventable AE per 1000 days of hospitalisation (control 60.4 (37.5-97.4) vs intervention 60.4 (33.2-109.9), p=0.99, risk ratio: 1.0 (0.74-1.34)), and no changes in the categories or AE types. We evaluated 841 handoffs: 396 in the control period and 445 in the intervention period. Compliance with all items in the verbal and written handoffs was significantly higher in the intervention group. We observed no difference in the handoff time in both periods (control 35.7 min (29.6-41.8) vs intervention 34.7 min (26.5-42.1); difference 1.43 min (95% CI -2.63 to 5.49, p=0.49)). The providers' perception of improved communication did not change. Conclusions After the implementation of the I-PASS bundle, compliance with handoff items improved. Nevertheless, no differences were observed in the AEs' frequency or the perception of enhanced communication. |
| publishDate |
2021 |
| dc.date.none.fl_str_mv |
2021-10 |
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info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://purl.org/coar/resource_type/c_6501 info:ar-repo/semantics/articulo |
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article |
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publishedVersion |
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http://hdl.handle.net/11336/165447 Jorro Baron, Facundo Ariel; Suarez Anzorena, Inés; Burgos Pratx, Rodrigo; De Maio, Noelia; Penazzi, Matiás; et al.; Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trial; BMJ Publishing Group; BMJ Quality and Safety; 30; 10; 10-2021; 782-791 2044-5415 CONICET Digital CONICET |
| url |
http://hdl.handle.net/11336/165447 |
| identifier_str_mv |
Jorro Baron, Facundo Ariel; Suarez Anzorena, Inés; Burgos Pratx, Rodrigo; De Maio, Noelia; Penazzi, Matiás; et al.; Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: A stepped-wedge trial; BMJ Publishing Group; BMJ Quality and Safety; 30; 10; 10-2021; 782-791 2044-5415 CONICET Digital CONICET |
| dc.language.none.fl_str_mv |
eng |
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eng |
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info:eu-repo/semantics/altIdentifier/doi/10.1136/bmjqs-2020-012370 info:eu-repo/semantics/altIdentifier/url/https://qualitysafety.bmj.com/content/30/10/782 |
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BMJ Publishing Group |
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BMJ Publishing Group |
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CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas |
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dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar |
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