Improving patient transfer between the Intensive Care Unit and the Medical/Surgical floor of a 200-bed hospital in southern California.

This paper describes the work of a front-line team at a 200-bed hospital in southern California to improve the patient transfer process between the Intensive Care Unit (ICU) and the Medical/Surgical floors. Using a phased approach of assessing the problem, identifying opportunities, testing ideas, and then implementing successful ideas, the team was able to improve patient transfer time from the ICU to the Medical/Surgical Floor once the bed is assigned from 6 to < 2 hr and to reduce the number of patients experiencing extreme delays (more than 12 hr waits since the bed is assigned) from 15% to 0%. Also, as a corollary of this work, nursing overtime was reduced by 25% year to year between March 2008 and March 2009 and patient satisfaction scores were improved. A key success factor of the front-line team was the implementation of a sustainability plan where metric and process accountability is specified, together with alert flags for the metrics and actions to take if the alert flags are triggered.