I Need Clarification: A Quality Improvement Projection to Increase Communication in an Ambulatory Outpatient Oncology Clinic
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Authors
Anderson, Megan
Issue Date
2024-05-09
Volume
Issue
Type
Poster
Language
Keywords
Communication , Communication Tool , Communication Failure
Alternative Title
Abstract
Background: Communication failure is costly, causing 1,744 patient deaths and 7,149 malpractice cases over a 5-year period and incurring 1.7 billion in total losses in the U.S. An ambulatory outpatient oncology unit at an academic health system identified communication issues between providers and clinic staff leading to delayed treatments and risk of patient harm. National organizations suggest addressing communication failures through use of communication tools, such as the I-PASS.
Sample/Setting: Use of an I-PASS dot phrase was initiated in the clinic’s electronic health record (EHR) for communication between the 17 medical providers and the nursing staff within the infusion department.
Methods: The I-PASS dot phrase was used in communicating patient treatment plans over a 10-week period. Data was collected before and throughout the project period with an audit tool to identify I-PASS utilization rates and impact on communication failures and adverse communication-related events. A total of 6119 charts were audited with 2025 eligible I-PASS encounters. In the last two weeks, 15 staff and 5 providers gave qualitative survey feedback on acceptability and usability of the I-PASS tool.
Results: Total I-PASS utilization was 35.5% among providers. I-PASS was not used in 83% of communication incidences. Outcomes included a 97.7% decrease in total time clarifying orders, 77% decrease in total daily order clarifications, 63.8% decrease in patient wait time, and 75% decrease in total communication-related adverse events during I-PASS implementation.
Conclusion: I-PASS dot phrase use improved communication among clinic and infusion staff. Staff expressed satisfaction and medical providers reported quick, easy use.
Description
Citation
Publisher
Creighton University
License
Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University