Background and Purpose:
The
transfer of patients with ischemic stroke from the intensive care unit
(ICU) to noncritical care inpatient wards involves detailed information
sharing between care teams. Our local transfer process was not
standardized, leading to potential patient risk. We developed and
evaluated an “ICU Transfer Checklist” to standardize communication
between the neurocritical care team and the stroke ward team.
Methods:
Retrospective
review of consecutive patients with ischemic stroke admitted to the
neurocritical care unit who were transferred to the stroke ward was used
to characterize transfer documentation. A multidisciplinary team
developed and implemented an ICU Transfer Checklist that contained a
synthesis of the patient’s clinical course, immediate “to-do” action
items, and a system-based review of active medical problems.
Postintervention checklist utilization was recorded for 8 months, and
quality metrics for the postintervention cohort were compared to the
preintervention cohort. Providers were surveyed pre- and
postintervention to characterize perceived workflow and quality of care.
Results:
Patients
before (n = 52) and after (n = 81) ICU Transfer Checklist
implementation had similar demographic and clinical characteristics. In
the postchecklist implementation period, the ICU Transfer Checklist was
used in over 85% of patients and median hospital length of stay (LOS)
decreased (8.6 days vs 5.4 days,
P = .003), while ICU readmission
rate remained low. The checklist was associated with improved
perceptions of safety and decreased time needed to transfer patients.
Conclusions:
Use
of the standardized ICU Transfer Checklist was associated with
decreased hospital LOS and with improvements in providers’ perceptions
of patient safety.
No comments:
Post a Comment