Impact of I-PASS handover training on compliance and communication quality: a clinical audit at a teaching hospital.

Abstract

Background: Clinical handover between the emergency department (ED) and inpatient units is a high-risk process prone to communication errors and patient harm. This audit evaluated ED-to-internal medicine handover practices and assessed the impact of implementing an I-PASS-based standardized framework.

Methods: A prospective closed-loop clinical audit was conducted at a public teaching hospital in Sudan in April 2024. Baseline data were collected via a structured questionnaire assessing compliance with I-PASS criteria, with a target standard of 100%. Thirteen questionnaire responses were analyzed in the first cycle. Following gap identification, a structured bedside I-PASS handover was implemented and reassessed in a second cycle.

Results: Baseline handovers were informal and unstructured, with no standardized tool in use. All handovers were verbal; 30.8% occurred via telephone. Critical safety elements were inconsistently communicated: pending investigations were mentioned in 15.4% of cases, isolation precautions in 7.7%, risk identification in 46.2%, and next-step review in 38.5%. Patient or family involvement occurred in only 7.7% of cases. Following I-PASS implementation, structured bedside handovers were universally adopted. Core clinical elements achieved complete or near-complete compliance. Patient or family involvement increased from 7.7 to 92.3%.

Conclusion: Baseline handover practices were variable and nonstandardized. I-PASS implementation was associated with improved handover compliance and perceived communication quality across all measured domains. Standardized handover is feasible in resource-limited settings, although further studies incorporating clinical outcome measures are needed.