Michael E Detsky1, Jonathan Ailon2, Adina S Weinerman3, Andre C Amaral4, Chaim M Bell5. 1. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA. Electronic address: mdetsky@mtsinai.on.ca. 2. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, St Michael's Hospital, Toronto, Ontario, Canada. Electronic address: ailonj@smh.ca. 3. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada. Electronic address: weinerman@sunnybrook.ca. 4. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: andrecarlos.amaral@sunnybrook.ca. 5. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada. Electronic address: cbell@mtsinai.on.ca.
Abstract
INTRODUCTION: The transfer of patients from the intensive care unit (ICU) to the general medical ward is high risk for adverse events and health care provider dissatisfaction. We aimed to identify perceived practices, and what information is important to communicate during an ICU transfer. METHODS: This study used a self-administered questionnaire that surveyed physicians in 2 different hospitals. These physicians provide care in either the ICU or the general medical ward. Responses were evaluated with Likert scales and frequencies. RESULTS: A total of 121 physicians (54% response rate) completed the survey. Current practice most often includes written chart and telephone communication. Most providers (63.3%) believed that the current process is inadequate. Surprises are common (79% of respondents); and reported adverse events include medication errors (60.4%), aspiration (49.5%), and decreased level of consciousness requiring intervention (44.6%). The use of an ICU transfer tool is one potential mechanism of improving this process of care, and providers reported several items that may be useful. CONCLUSION: Providers reported the current process of transferring patients from the ICU to the general medical ward as inadequate. We highlight data that physicians feel is important to communicate at the time of transfer.
INTRODUCTION: The transfer of patients from the intensive care unit (ICU) to the general medical ward is high risk for adverse events and health care provider dissatisfaction. We aimed to identify perceived practices, and what information is important to communicate during an ICU transfer. METHODS: This study used a self-administered questionnaire that surveyed physicians in 2 different hospitals. These physicians provide care in either the ICU or the general medical ward. Responses were evaluated with Likert scales and frequencies. RESULTS: A total of 121 physicians (54% response rate) completed the survey. Current practice most often includes written chart and telephone communication. Most providers (63.3%) believed that the current process is inadequate. Surprises are common (79% of respondents); and reported adverse events include medication errors (60.4%), aspiration (49.5%), and decreased level of consciousness requiring intervention (44.6%). The use of an ICU transfer tool is one potential mechanism of improving this process of care, and providers reported several items that may be useful. CONCLUSION: Providers reported the current process of transferring patients from the ICU to the general medical ward as inadequate. We highlight data that physicians feel is important to communicate at the time of transfer.
Authors: Hayley D Germack; Renee Fekieta; Meredith Campbell Britton; Shelli L Feder; Alana Rosenberg; Sarwat I Chaudhry Journal: Nurs Open Date: 2019-12-17