Evidence map›Paper›PMID 37087711›Full record

Observational studyCJEM2023

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

Cara G Elliott, Lowyl Notario, Brian Wong, Arshia P Javidan, Dylan Pannell, Avery B Nathens, Homer Tien, Martin Johnston, Will Thomas-Boaz, Corey Freedman and 1 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in CJEM, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Cara G ElliottDepartment of Obstetrics and Gynaecology, Western University, London, ON, Canada.ORCID 0000-0003-3585-1166
Lowyl NotarioTory Regional Trauma Program and Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Brian WongDepartment of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Arshia P JavidanDepartment of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Dylan PannellTory Regional Trauma Program and Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Avery B NathensTory Regional Trauma Program and Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Homer TienTory Regional Trauma Program and Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Martin JohnstonToronto Paramedic Services, Toronto, ON, Canada.
Will Thomas-BoazTory Regional Trauma Program and Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Corey FreedmanTory Regional Trauma Program and Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Luis da LuzTory Regional Trauma Program and Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. luis.daluz@sunnybrook.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePatient 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.

methodsThis 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.

resultsOver 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.

Indexed as

Emergency Medical TechniciansPatient HandoffCohort StudiesCommunicationContinuity of Patient CareHumansParamedicsCommunicationHandover toolHigh performing teamsInjuryPatient handoverQuality improvementTeam performanceTrauma

Identifiers

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.