Impact of a Standardized Patient Hand-off Tool on Communication between Emergency Medical Services Personnel and Emergency Department Staff

Maddry, Joseph K.; Simon, Erica; Reeves, Lauren K; Mora, Alejandra G.; Clemons, Melissa A; Shults, Nicole M; Savell, Shelia C; Blessing, Alexis; Walrath, Benjamin

doi:10.1080/10903127.2020.1808745

Cited by 13 publications

(5 citation statements)

References 20 publications

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“…Our study is similar to the IMIST-AMBO study conducted in Australia, where the tool demonstrated a greater volume information communicated, less questions asked, shorter duration, and fewer repetitions [9]. Similarly, Maddry et al implemented the MIST section between paramedics and Emergency Department physicians and showed improved communication, handover flow, and provider satisfaction [15]. Finally, Nagaraj et al used video review to identify modifiable behaviors during handover processes that utilized MIST.…”

Section: Comparison To Other Studiessupporting

confidence: 70%

“…As such, IMIST-AMBO may aid in the educational of medical learners. Finally, as demonstrated by the Australian and Maddry [15] study, the benefits of a structured tool may improve recipient comprehension, information retention, and provider satisfaction. Future research should focus on the implementation of IMIST-AMBO in other health care regions and handover settings.…”

Section: Clinical and Research Implicationsmentioning

confidence: 94%

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Implementing the IMIST-AMBO tool for paramedic to trauma team handovers: a video review analysis

et al. 2023

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Objective Patient handover between paramedics and the trauma team is vulnerable to communication errors that may adversely affect patient care. This study assesses the feasibility of a handover tool, IMIST-AMBO (acronym of categories), implementation in the trauma bay and evaluates the degree to which it improves handover metrics. Methods This is a prospective observational cohort study conducted at Canada's largest level-one trauma center. Feasibility of the tool implementation and improvement in handover metrics were assessed. Strategies for implementation included distribution of an educational video and posters, and point-of-care reminders in the trauma bay. Two reviewers independently assessed video recordings of handovers to evaluate handover metrics. Findings were compared to data obtained during a knowledge gap analysis conducted prior to the initiation of this study at the same institution. Results Over 13 weeks (August to November 2020), 140 videos were recorded, of which 80 used the IMIST-AMBO tool (compliance of 57%). Paramedic adherence to the handover structure occurred in 70.4% of cases, with greater adherence to the IMIST (82.2%) compared to the AMBO (47.1%) section. The mean (± standard deviation) handover duration was shorter (1 min:58 s ± 0:44 s during implementation vs. 2 min:47 s ± 1:14 s pre-implementation, [p < 0.001]). Frequency of parallel conversations and informal handovers improved (61% to 30% and 65% to 13%, [p < 0.001], respectively). Interruptions during the handover decreased from 3.05 (± 1.95) to 1.5 (± 1.7), p < 0.001. The tool was received favorably among study participants. ConclusionThe IMIST-AMBO tool reduced the frequency of interruptions, parallel conversations, and informal handovers during paramedic-trauma team handovers at our institution. The quality and amount of information communicated per handover improved, all with a decrease in handover duration. The IMIST-AMBO tool may be applied to other trauma centers across Canada, or more broadly on an international scale.

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Section: Comparison To Other Studiessupporting

confidence: 70%

Section: Clinical and Research Implicationsmentioning

confidence: 94%

Implementing the IMIST-AMBO tool for paramedic to trauma team handovers: a video review analysis

et al. 2023

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“…Unlike SBAR, where there has not been extensive study of prehospital use, MIST has been studied in multiple centers, including the Southwest Texas Regional Advisory Council, which published one of the largest studies of its use involving over 100 prehospital clinicians pre and post implementation. The overwhelming results of the implementation show that all involved felt that communication between the hospital and prehospital team improved [31]. In 2019, the Commonwealth of Pennsylvania implemented the use of DMIST statewide with a small modification, adding the D for demographics at the beginning [32].…”

Section: Dmistmentioning

confidence: 99%

Patient Safety in Emergency Medical Services

Wilson¹,

Woodrow²

2023

Contemporary Topics in Patient Safety - Volume 2

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Patients deserve high-quality, evidence-based care delivered from the moment they call for help to the moment they are safely delivered to the hospital. Often patient safety is not viewed as a fun or exciting topic by prehospital clinicians, but it need not be a burden. A culture of safety in emergency medical services can enhance patient outcomes and improve the overall safety in a community. The design and structure of the ambulance are the first layer of protection for patients. Couple that with ambulance operations topics, such as speed and light and siren use and that covers a large swath of the patient safety engineered into the system. There are patient-focused topics such as medication safety protocols, structured handoffs, and competency assessments of high-risk procedures that all serve to increase patient safety. Lastly, an emergency medical services clinician-oriented topic that also heavily impacts our patients is fatigue mitigation. Actively addressing fatigue and employing fatigue mitigation strategies can be used to enhance the safety of patients and will likely enhance the experience of prehospital clinicians in the organization.

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“…In simulation B (November 2018), 60 cardboard box 'patients' were made with abbreviated clinical details using common trauma nomenclature (Age, Time of Injury, Mechanism, Injuries, Signs, and Treatment [ATMIST]). 19 This low-fidelity/low-cost approach was chosen for reproducibility and to focus attention on the system rather than clinical management. Radiology findings, operative findings, and unique identifiers for reunifying with 'relatives' were contained within the box to guide simulation participants in management trajectories.…”

Section: Whole Hospital Simulation: Exercisesmentioning

confidence: 99%