I-PASS Shift Handover Template

Shift handover by I-PASS: unit overview, illness severity, patient summary, action list, contingencies, receiver synthesis, completion checks

Y tếChuẩnI-PASS (Starmer et al., N Engl J Med 2014)ipass handoverCập nhật 29 thg 10, 2026

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Cách dùng: Use it for end-of-shift or team handover of a group of patients. Fill the illness severity and the action list with owners and times first. The main pitfall is skipping the receiver's synthesis and read-back.

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I-PASS Shift Handover: [Unit, date, shift]

Structured written and verbal shift handover using I-PASS: Illness severity, Patient summary, Action list, Situation awareness and contingency planning, Synthesis by receiver. I-PASS was evaluated in Starmer AJ et al., "Changes in medical errors after implementation of a handoff program", N Engl J Med 2014;371(19):1803-1812, where a handoff bundle across nine paediatric residency programmes was associated with fewer medical errors and preventable adverse events. Replace every [bracketed] value and every row marked Example. This is a communication format, not medical advice; follow local policy and clinical judgement. Use fictional data in examples, and keep real handover lists inside your clinical system.

Document control

Field	Value
Document ID	[HO-YYYY-MM-DD-UNIT-SHIFT]
Unit / team	[Ward, service, team]
Shift	[Day / evening / night / weekend]
Giver	[Name, role, contact]
Receiver	[Name, role, contact]
Date / time of handover	YYYY-MM-DD HH:MM
Number of patients	[N]
Version	[1.0]
Status	[Prepared / Handed over / Read back confirmed]
Owner	[Giver]
Approvers/reviewers	[Not applicable for one shift / unit lead for a change to the sheet]
Last updated	YYYY-MM-DD HH:MM
Classification	[Confidential: patient information]

Revision history

Version	Date	Author	Change
1.0	YYYY-MM-DD	[Name]	Sheet prepared for handover
1.1 (Example)	YYYY-MM-DD	[Name]	Updated after receiver read-back

1. Unit overview

Item	Detail
Staffing and gaps	[Who is on, who is missing, escalation contact]
Beds and expected admissions	[Free beds, expected arrivals]
Watchers and unstable patients	[Count, bed numbers]
Outstanding unit tasks	[Equipment, audits, safety issues]

2. Illness severity

Category	Meaning	What the receiver should expect
Stable	Expected to stay well over the shift	Routine review
Watcher	Uncertain, at risk of getting worse	Planned check at a stated time, low threshold to escalate
Unstable	Getting worse or needs active intervention now	Immediate review, senior aware

Order the patient list below as unstable first, then watchers, then stable patients.

3. Patient handover entries

Patient [bed or identifier]

I-PASS element	Content
Illness severity	[Stable / watcher / unstable]
Patient summary	[Age, reason for admission, key problems, current treatment, relevant history, code or escalation status, allergies]
Action list	[Task, owner, time due; mark each done or not done at the end of shift]
Situation awareness and contingency planning	[What is happening now, and if [change], then [action]]
Synthesis by receiver	[Receiver's summary, questions asked, actions read back]

Example: fictional patient, bed 14, Ward 5, Halvermoor District Hospital.

I-PASS element	Content
Illness severity	Watcher
Patient summary	81 years old, admitted yesterday with community-acquired pneumonia, on intravenous antibiotics day 2 and 2 L oxygen. Background of heart failure and chronic kidney disease. Penicillin allergy (rash). For full escalation.
Action list	1. Check potassium result from 18:00 sample, receiver, by 20:00. 2. Review fluid balance at 22:00, receiver. 3. Antibiotic level due 06:00, phlebotomy requested, giver has done the form.
Situation awareness and contingency planning	Breathing better than this morning. If oxygen need rises above 4 L or respiratory rate above 25, call the medical registrar and repeat chest X-ray. If potassium is above 6.0, follow the hyperkalaemia protocol and call the registrar.
Synthesis by receiver	Receiver repeated: watcher, check potassium by 20:00, fluid balance at 22:00, escalate if oxygen above 4 L or respiratory rate above 25. Asked whether diuretics were held today: yes, held at 08:00. Giver confirmed.

Copy the block for each patient.

4. Verbal handover sequence

The giver leads the first five steps; the receiver leads the synthesis, and the giver closes the loop before moving to the next patient.

5. Handover completion

Check	Done
All patients on the list handed over	[Yes / no: which remain]
Every unstable and watcher patient read back by the receiver	[Yes / no]
Action list transferred with owners and times	[Yes / no]
Interruptions	[None / emergency, handover resumed at HH:MM]
Giver available after handover until	HH:MM, contact [number]

6. Quality checks for the unit

ID	Observation item	Target (Example)
HQ-01	Illness severity stated for every patient	100% of observed patients
HQ-02	Every contingency written as "if, then"	90% of watcher and unstable patients
HQ-03	Receiver synthesis observed	100% of watcher and unstable patients
HQ-04	Handover finished without non-urgent interruption	80% of observed handovers

To test an improvement in these items, use a PDSA cycle (healthcare/pdsa-cycle).

References

Reference	Status	Use
Starmer AJ, Spector ND, Srivastava R, et al. Changes in medical errors after implementation of a handoff program. N Engl J Med 2014;371(19):1803-1812, https://doi.org/10.1056/NEJMsa1405556	Citation checked on PubMed (PMID 25372088), 2026-10-30	Mnemonic and evidence: errors 24.5 to 18.8 per 100 admissions, preventable adverse events 4.7 to 3.3 per 100 admissions
I-PASS Patient Safety Institute, https://www.ipassinstitute.com/	Checked 2026-10-30	Developer's training and written handoff tool. Official materials: I-PASS Patient Safety Institute, licensed access via the same site
AHRQ TeamSTEPPS 3.0, Tool: I-PASS, https://www.ahrq.gov/teamstepps-program/curriculum/communication/tools/ipass.html	Not re-checked (site blocked automated access)	I-PASS as a team communication tool

Standard and licence note

Based on the public I-PASS mnemonic as published by Starmer et al. (N Engl J Med, 2014). This template is original text written for this collection and does not reproduce the I-PASS curriculum or the developer's written handoff tool, which are available from I-PASS Patient Safety Institute. All names, wards and clinical details in examples are fictional. This is a communication format, not medical advice; follow local policy and clinical judgement, and check the current official pages. Template licence: MIT.

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