Background/Introduction: Formal hand-off process is essential for safe patient transition of care. Structured hand-off at our institution was implemented using the IPASS module. In addition to the in-person sign-out process, a shared spreadsheet was implemented to the existing GME admission tracker document in-order to augment and reinforce the follow-up by the residents on night-float for “watcher” and “unstable” patients.

Methods: Review of the transition of care and types of hand-offs along with the IPASS module were presented as a lecture during the orientation week of the class of 2026. Full participation of all GME internal medicine residents was required for this lecture. Verbal sign-out was reinforced through faculty periodic monitoring of residents during day-to-night sign out. Multiple e-mail reminders were distributed by the chief residents. Evaluation of deficiencies were discussed as part of townhall meetings. Assessment of Pre/Post implementation was done through the ACGME survey as well as a post-implementation survey which was distributed to PGY2/PGY3 residents. Descriptive statistics were used to evaluate the success of the implementation.

Results: ACGME annual survey 2023/2024 (pre/post IPASS implementation) responses to “information not lost during shift changes, patient transfers, or the hand-over process” revealed (65%, 3.7/5.0; N=69/72) and (77%, 3.9/5.0; N=70/71). Survey responses to PGY2 and PGY3 revealed a mean rating of 3.61/5.0.

Discussion: The transition of care process was successfully improved through the implementation of the IPASS module to structure sign out at our program. Furthermore, application of a shared spreadsheet was useful in the follow-up for watcher and unstable patients by residents covering night-float. This year, expansion of the QI initiative will implement the IPASS as part of the bootcamp for the incoming residents, the lecture reviewing the transition of care process will also be included in this years orientation series.