Evaluating the Quality of Patient Handoff Communication in the Department of Medicine at Dongola Specialized Hospital

Background Communication failure at the point of handoff is one of the most significant preventable medical errors, especially in resource-scarce settings. Worldwide, the use of the I-PASS (Illness severity, Patient summary, Action list, Situation awareness and contingency planning, and Synthesis by receiver) tool has been shown to improve the accuracy and consistency of handovers of patients. The quality improvement audit was to assess and optimize patient handoff through the structured utilization of the I-PASS tool for Dongola Specialized Hospital in Sudan. Methods A prospective three-cycle audit, the Department of Medicine of Dongola Specialized Hospital was subjected to three rounds of quality improvement audit between 2 November 2023 and 11 September 2025. All clinical handoffs by medical officers, registrars, and house officers were observed. Standards for the audit were derived from the I-PASS system, covering illness severity, patient summary, action list, situational awareness, and synthesis by receiver. Compliance was recorded through structured observation checklists, and focused intervention included role-plays, training workshops, and standard checklists. Chi-square testing was used for statistical analysis. Results Cycle 1 (n = 37) demonstrated poor baseline compliance: illness severity (21.6%), summary statements (10.8%), and continuous assessment (8.1%). Meaningful improvements were observed at Cycle 2 (n = 74), such as illness severity (68.9%) and summary statements (93.2%), although timeline/ownership (41.9%) and receiver synthesis (2.7%) declined. In Cycle 3 (n = 86), continued and comprehensive improvements were achieved: illness severity (96.5%), summary statements (100%), continuous assessment (98.8%), and plan documentation (95.3%). Receiver synthesis improved to 88.4%, question-asking to 80.2%, and ownership to 100%. Chi-square analysis confirmed statistically significant improvements in all parameters (p < 0.0001). Conclusion Orderly implementation of the I-PASS communication framework significantly increased the safety, thoroughness, and precision of Dongola Specialized Hospital's patient transitions. Incremental improvements noted over three rounds reiterated the value of educational activities, follow-up audits, and institutional support for institutionalizing structured communication methodologies. Extension of the I-PASS model to additional departments and medical facilities in Sudan can potentially improve patient safety in a precarious healthcare environment.