Adapting the I-PASS handoff program for emergency department inter-shift handoffs

James A. Heilman, Moira Flanigan, Anna Nelson, Tom Johnson, Lalena M. Yarris

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Introduction: Academic emergency department (ED) handoffs are high-risk transfer of care events. Emergency medicine residents are inadequately trained to handle these vital transitions. We aimed to explore what modifications the I-PASS (illness severity, patient summary, action list, situation awareness and contingency plans, and synthesis by receiver) handoff system requires to be effectively modified for use in ED inter-shift handoffs. Methods: This mixed-method needs assessment conducted at an academic ED explored the suitability of the I-PASS system for ED handoffs. We conducted a literature review, focus groups, and then a survey. We sought to identify the distinctive elements of ED handoffs and discern how these could be incorporated into the I-PASS system. Results: Focus group participants agreed the patient summary should be adapted to include anticipated disposition of patient. Participants generally endorsed the order and content of the other elements of the I-PASS tool. The survey yielded several wording changes to reflect contextual differences. Themes from all qualitative sources converged to suggest changes for brevity and clarity. Most participants agreed that the I-PASS tool would be well suited to the ED setting. Conclusion: With modifications for context, brevity, and clarity, the I-PASS system may be well suited for application to the ED setting. This study provides qualitative data in support of using the I-PASS tool and concrete suggestions for how to modify the I-PASS tool for the ED. Implementation and outcome research is needed to investigate if the I-PASS tool is feasible and improves patient outcomes in the ED environment.

Original languageEnglish (US)
Pages (from-to)756-761
Number of pages6
JournalWestern Journal of Emergency Medicine
Issue number6
StatePublished - 2016


  • Handoff
  • Patient safety
  • Resident communication
  • Sign-out
  • Transitions of care

ASJC Scopus subject areas

  • Emergency Medicine


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