Becker's Clinical Quality & Infection Control

14 QUALITY IMPROVEMENT & MEASUREMENT Structured patient handoffs cut adverse effects by nearly 50%, researchers find By Nika Schoonover T he I-PASS Handoff Program, created to improve handoff miscommunications when providers change shis, resulted in a 47 percent reduction in adverse events, a study found. e study, published Nov. 3 in the Journal of Hospital Medicine, engaged 32 diverse hospitals that included adult, pediatric, academic and community hospitals. At each hospital, supervising physicians oversaw more than 3,000 patient handoffs before, during, and aer program implementation and data collection. e I-PASS team also separately reviewed 1,620 written handoff documents. I-PASS, a package of communication and training tools, stands for illness severity, patient summary, action list, situational awareness/contingency planning, and synthesis of the information by the incoming provider — in other words, the information that needs to be passed on during handoffs. Boston Children's Hospital pediatricians Christopher Landrigan, MD, and Amy Starmer, MD, study authors and co-creators of the I-PASS system, were surprised to find the program's improvements were consistent across the board. "Handoff is a universal issue in healthcare," Dr. Landrigan said in a Dec. 2 news release from Boston Children's. "We think we've created a universal language for handoffs. e challenge now is to implement the program at scale across hospitals." e study also found improvements in the completeness and quality of handoff communications: 66 percent of verbal handoffs were completed, and incoming providers were able to give a high-quality synthesis of information they received 83 percent of the time. Written handoffs were complete 74 percent of the time. ese findings come aer a 2014 study in the New England Journal of Medicine, in which Dr. Starmer, Dr. Landrigan and colleagues implemented I-PASS at children's hospitals. ough they found improved communication and a 30 percent reduction in serious, preventable medical errors, they wanted to see if it would work with adults and in other types of hospitals. Now, they want to expand the I-PASS program by co-founding a startup company, I-PASS Patient Safety Institute. e company is working with about 50 hospitals to launch handoff programs at scale and offering training, cloud- based tools and support for medical records systems. n Dementia rates fell 30% over 16 years — working and education may deserve credit By Mariah Taylor R esearchers from RAND Corporation, a nonprofit think tank, found dementia rates dropped by 30.1 percent among individuals 65 and older over a 16-year period. The study, published Nov. 7 in PNAS, analyzed data between 2000 and 2016 and sorted it by age, gender, race and ethnicity, education and lifetime earnings. Overall, dementia prevalence among men dropped by 40 percent, while it went down by 20 percent for women. Three other findings: 1. Dementia prevalence in non-Hispanic Black men dropped from 17.2 percent in 2000 to 9.9 percent in 2016.. 2. Researchers found an increase in education among participants with college-educated men increasing from 21.5 percent in 2000 to 33.7 percent in 2016, and college-educated women increasing from 12.3 percent to 23 percent. 3. Researchers also found an increase in working women. Of participants ages 74 to 84, 29.5 percent worked for more than 30 years during their lifetime in 2000; that increased to 59 percent in 2016. "There's a need for more research on the effect of employment on cognitive reserve. It's plausible that working is good for your mental cognitive abilities," study investigator Péter Hudomiet, PhD, told Medscape Medical News. n Delaying surgery after COVID-19 infection can prevent heart issues By Mariah Taylor A study found that delaying surgery after a COVID-19 infection reduced the risk of major postoperative heart events. The study, published in JAMA Network Open, followed 3997 patients who had surgery after a COVID-19 infection. Patients underwent surgery anywhere from 30 days to 225 days, with a median time of 98 days post-infection. Only 12.1 percent of patients experienced a postoperative major heart event. Increasing the time between infection and surgery was associated with decreased risk of cardiovascular events in both vaccinated and unvaccinated patients. n

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