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. 2018 Dec;10(6):702-706.
doi: 10.4300/JGME-D-18-00178.1.

I-CATCH: A Novel Bundle to Improve Postcall Morning Handoffs

Jonathan S Zipursky, Gousia Dhhar, Adina Weinerman, Lynfa Stroud, Brian M Wong

I-CATCH: A Novel Bundle to Improve Postcall Morning Handoffs

Jonathan S Zipursky et al. J Grad Med Educ. 2018 Dec.

Abstract

Background: Conducting postcall morning handoffs using a resident handoff bundle such as I-PASS can prove challenging. This may delay recognizing and acting on clinically important patient issues that arose overnight.

Objective: We developed and implemented the I-CATCH morning handoff bundle and evaluated its impact on the proportion of overnight patient issues handed off from the on-call resident to the daytime team.

Methods: We evaluated the I-CATCH (Identify patient; Characterize situation; Action-what was done overnight?; To do for the team in the morning; Confirm the Handoff) handoff bundle from November 2015 to May 2016 on general internal medicine wards at 1 academic teaching hospital. The bundle entailed staff/resident training, structured communication, and dedicated handoff space and time. We compared handoffs of overnight on-call issues by evening resident to daytime medical team before and after implementation, and used statistical process control to analyze adherence to the mnemonic.

Results: We observed 435 handoffs (242 pre- and 193 postimplementation) over 63 days. There was no significant association between I-CATCH implementation and proportion of on-call overnight issues handed off (OR = 0.96; 95% confidence interval [CI] 0.52-1.47; P = .85). Running the list by going through patients one-by-one (OR = 1.74; 95% CI 1.1-2.77; P = .019), progress note documentation (OR = 3.80; 95% CI 2.19-6.60; P < .001), and direct handoff (OR = 4.84; 95% CI 1.43-16.42; P = .011) correlated with an increased likelihood of morning handoff.

Conclusions: Implementing the I-CATCH bundle did not improve handoff of overnight issues to the daytime team.

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Conflict of interest statement

Conflict of interest: The authors declare they have no competing interests.

Figures

Figure
Figure
Statistical Process Control Chart for Morning Handoffs Adhering to Structured I-CATCHa a Plan, do, study, act cycles to implement the I-CATCH bundle occurred between weeks 11 and 17. Note: Diamonds on the graph represent special cause variation, whereas square points are common cause variation.
See this image and copyright information in PMC

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