Jamie M Boyd1, Derek J Roberts2, Jeanna Parsons Leigh3, Henry Thomas Stelfox4. 1. Departments of Critical Care Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. 2. Department of Surgery, University of Calgary and the Foothills Medical Centre, Calgary, Alberta, Canada. 3. Departments of Critical Care Medicine, O'Brien Institute for Public Health, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada. 4. Departments of Critical Care Medicine, Medicine and Community Health Sciences, O'Brien Institute for Public Health, University of Calgary and Alberta Health Services - Calgary Zone, Calgary, Alberta, Canada. tstelfox@ucalgary.ca.
Abstract
BACKGROUND: The transfer of critically ill patients from the intensive care unit (ICU) to hospital ward is challenging. Shortcomings in the delivery of care for patients transferred from the ICU have been associated with higher healthcare costs and poor satisfaction with care. Little is known about how hospital ward providers, who accept care of these patients, perceive current transfer practices nor which aspects of transfer they perceive as needing improvement. OBJECTIVE: To compare ICU and ward administrator perspectives regarding ICU-to-ward transfer practices and evaluate the content of transfer tools. DESIGN: Cross-sectional survey design. PARTICIPANTS: We administered a survey to 128 medical and/or surgical ICU and 256 ward administrators to obtain institutional perspectives on ICU transfer practices. We performed qualitative content analysis on ICU transfer tools received from respondents. KEY RESULTS: In total, 108 (77%) ICU and 160 (63%) ward administrators responded to the survey. The ICU attending physician was reported to be "primarily responsible" for the safety (93% vs. 91%; p = 0.515) of patient transfers. ICU administrators more commonly perceived discharge summaries to be routinely included in patient transfers than ward administrators (81% vs. 60%; p = 0.006). Both groups identified information provided to patients/families, patient/family participation during transfer, and ICU-ward collaboration as opportunities for improvement. A minority of hospitals used ICU-to-ward transfer tools (11%) of which most (n = 21 unique) were designed to communicate patient information between providers (71%) and comprised six categories of information: demographics, patient clinical course, corrective aids, mobility at discharge, review of systems, and documentation of transfer procedures. CONCLUSION: ICU and ward administrators have similar perspectives of transfer practices and identified patient/family engagement and communication as priorities for improvement. Key information categories exist.
BACKGROUND: The transfer of critically illpatients from the intensive care unit (ICU) to hospital ward is challenging. Shortcomings in the delivery of care for patients transferred from the ICU have been associated with higher healthcare costs and poor satisfaction with care. Little is known about how hospital ward providers, who accept care of these patients, perceive current transfer practices nor which aspects of transfer they perceive as needing improvement. OBJECTIVE: To compare ICU and ward administrator perspectives regarding ICU-to-ward transfer practices and evaluate the content of transfer tools. DESIGN: Cross-sectional survey design. PARTICIPANTS: We administered a survey to 128 medical and/or surgical ICU and 256 ward administrators to obtain institutional perspectives on ICU transfer practices. We performed qualitative content analysis on ICU transfer tools received from respondents. KEY RESULTS: In total, 108 (77%) ICU and 160 (63%) ward administrators responded to the survey. The ICU attending physician was reported to be "primarily responsible" for the safety (93% vs. 91%; p = 0.515) of patient transfers. ICU administrators more commonly perceived discharge summaries to be routinely included in patient transfers than ward administrators (81% vs. 60%; p = 0.006). Both groups identified information provided to patients/families, patient/family participation during transfer, and ICU-ward collaboration as opportunities for improvement. A minority of hospitals used ICU-to-ward transfer tools (11%) of which most (n = 21 unique) were designed to communicate patient information between providers (71%) and comprised six categories of information: demographics, patient clinical course, corrective aids, mobility at discharge, review of systems, and documentation of transfer procedures. CONCLUSION: ICU and ward administrators have similar perspectives of transfer practices and identified patient/family engagement and communication as priorities for improvement. Key information categories exist.
Entities:
Keywords:
care transitions; continuity of care; intensive care units; qualitative analysis; survey research
Authors: F Shaun Hosein; Derek J Roberts; Tanvir Chowdhury Turin; David Zygun; William A Ghali; Henry T Stelfox Journal: Crit Care Date: 2014-12-31 Impact factor: 9.097
Authors: Emily McKenzie; Melissa L Potestio; Jamie M Boyd; Daniel J Niven; Rebecca Brundin-Mather; Sean M Bagshaw; Henry T Stelfox Journal: Health Expect Date: 2017-05-31 Impact factor: 3.377
Authors: Brianna K Rosgen; Kara M Plotnikoff; Karla D Krewulak; Anmol Shahid; Laura Hernandez; Bonnie G Sept; Jeanna Morrissey; Kristin Robertson; Nancy Fraser; Daniel J Niven; Sharon E Straus; Jeanna Parsons Leigh; Henry T Stelfox; Kirsten M Fiest Journal: BMC Health Serv Res Date: 2022-01-02 Impact factor: 2.655