The patient population was narrowed to only patients hospitalized on a teaching internal medicine service, so results may differ for other clinical services. Third, the study did not account for overnight escalation of care through ICU transfers or code blue events in the absence of an RRT activation. Methods We conducted a prospective pre-post intervention study on a paediatric intensive care unit in 20112012. We sought to determine the impact of a handoff improvement programme for nurses. Second, this study focused on overnight RRT activations so extrapolation of risk predictability to daytime activations is limited. Background and objective Handoff communication errors are a leading source of sentinel events. Training in how to categorize patients is very important, and this study demonstrated some variability in how this may be interpreted by different residents. With variability in the implementation of RRT across hospitals, general applicability may be limited. First, it was conducted at a single institution with residents from a single internal medicine residency program. This project adapted the IPASS method for patient. Chirayu Shah, MD, MEd, is Associate Professor, Department of Medicine, Baylor College of Medicine, and Clinical Faculty, Harris Health System Khaled Sanber, MD, is Internal Medicine Resident, Department of Medicine, Baylor College of Medicine Rachael Jacobson, MD, is Internal Medicine Resident, Department of Medicine, Baylor College of Medicine Bhavika Kaul, MD, is Chief Internal Medicine Resident, Department of Medicine, Baylor College of Medicine, and Chief Resident, Harris Health System Sarah Tuthill, MD, is Internal Medicine Resident, Department of Medicine, Baylor College of Medicine Vagish Hemmige, MD, is Associate Professor, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center Elizabeth Guy, MD, is Assistant Professor, Department of Medicine, Baylor College of Medicine, and Clinical Faculty, Harris Health System and Stephen Greenberg, MD, is Distinguished Service Professor, Departments of Medicine, Microbiology, and Immunology, Baylor College of Medicine, and Chief of Medicine Service and Vice Chief of Staff for Academic and Educational Affairs, Harris Health System. One mnemonic handoff system, IPASS, has demonstrated a 30 reduction in preventable patient harm.
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