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Improving Oncology Outpatient Transfer of Care Communication: Implementation of the I-PASS Tool

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Redmond, Erica
Date
2025-05
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Peer Reviewed
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DNP Project
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Problem: The research hospital in Maryland provides inpatient and outpatient care for cancer patients. The oncology infusion center receives patients from the outpatient specialty clinics for treatment. From 2021 to 2022, the infusion center’s clinical safety reports increased from 21 to 87, respectively. Safety report evaluation revealed communication breakdown and the absence of standardized communication as the foundation for event occurrences. Evidence demonstrates that standardized handoffs improve inter-communication and decreases medical errors. The I-PASS is a standardized handoff program that supports communication fidelity. The mnemonic stands for (I)llness severity, (P)atient summary, (A)ction, (S)ituation, and (S)ynthesis by receiver The I-PASS tool is used for inpatient handoffs at the research hospital; however, there is no standardized communication procedure for outpatient care handoffs. Purpose: The purpose of this 15-week quality improvement project is to implement the electronic medical record integrated I-PASS tool as a standardized communication approach for outpatient care transfer. Methods: After finalizing the treatment plan, patients starting new cancer treatments (n=15) had their handoff information entered into the I-PASS tool by the research nurse. The assigned infusion nurse viewed the I-PASS information prior to initiating patient care and completed an experience survey after treatment completion. Weekly patient chart audits for I-PASS tool completion were performed. Monthly infusion center safety data were evaluated for communication related medical error trends. Results: Results showed 100% I-PASS completion compliance. Two-sample t-test showed no statistically significant difference in communication safety report numbers between the pre-implementation group (M=5.67, SD=3.79) and the implementation group (M=5.3, SD=.577); t(3)=.48, p=.343. Surveys responses showed that I-PASS was easy to locate, understand, and use. It was an appropriate length and captured the key components required for comprehensive patient handoff. Conclusion: The benchmark was met for 100% I-PASS tool completion compliance. I-PASS was deemed accessible, effective, and efficient by nurses. The sample size was too small for statistically significant data inferences. Large-scale implementation is needed to evaluate impact and to inform sustainability.

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