Identifying intensive care unit discharge planning tools: protocol for a scoping review

Background Transitions of care between providers are vulnerable periods in healthcare delivery that expose patients to preventable errors and adverse events. Patient discharge from the intensive care unit (ICU) to a medical or surgical hospital ward is one of the most challenging and high risk transitions of care. Approximately 1 in 12 patients discharged will be readmitted to ICU or die before leaving the hospital. Many more patients are exposed to unnecessary healthcare, adverse events and/or are disappointed with the quality of their care. Our objective is to conduct a scoping review by systematically searching the literature to identify ICU discharge planning tools and their supporting evidence-base including barriers and facilitators to their use. Methods and analysis Systematic searching of the published health literature will be conducted to identify the existing ICU discharge planning tools and supporting evidence. Literature (research and non-research) reporting on the tools used to facilitate decision making and/or communication at ICU discharge with patients of any age will be included. Outcomes will include adverse events and provider and patient/family-reported outcomes. Two investigators will independently review the abstracts (screen 1) to identify those meeting the inclusion criteria and then independently assess the full text articles (screen 2) to determine if they meet the inclusion criteria. Data collection will include information on citations and identified tools. A quality assessment will be performed on original research studies. A descriptive summary will be developed for each tool. Ethics and dissemination Our scoping review will synthesise the literature for ICU discharge planning tools and identify the opportunities for knowledge to action and gaps in evidence where primary evidence is necessary. This will serve as the foundational element in a multistep research programme to standardise and improve the quality of care provided to patients during ICU discharge. Ethics approval is not required for this study.

[1]  Steve Bhimji,et al.  Agency for Healthcare Research and Quality (AHRQ) , 2015 .

[2]  B. Afessa,et al.  Perceived effects of attending physician workload in academic medical intensive care units: A national survey of training program directors* , 2012, Critical care medicine.

[3]  Kay Caldwell,et al.  Developing a framework for critiquing health research: an early evaluation. , 2011, Nurse education today.

[4]  W. Ghali,et al.  A prospective observational study of physician handoff for intensive-care-unit-to-ward patient transfers. , 2011, The American journal of medicine.

[5]  Å. Engström,et al.  Being transferred from an intensive care unit to a ward : searching for the known in the unknown , 2011 .

[6]  P. Pronovost,et al.  How to use an article about quality improvement. , 2010, JAMA.

[7]  D. Levac,et al.  Scoping studies: advancing the methodology , 2010, Implementation science : IS.

[8]  Andrew F Goddard,et al.  Impact of EWTD on patient:doctor ratios and working practices for junior doctors in England and Wales 2009. , 2010, Clinical medicine.

[9]  Sharon E Straus,et al.  A systematic review of quality indicators for evaluating pediatric trauma care , 2010, Critical care medicine.

[10]  S. Straus,et al.  Quality indicators for evaluating trauma care: a scoping review. , 2010, Archives of surgery.

[11]  J. Padmore,et al.  Residents’ and Attending Physicians’ Handoffs: A Systematic Review of the Literature , 2009, Academic medicine : journal of the Association of American Medical Colleges.

[12]  Leora I. Horwitz,et al.  What are covering doctors told about their patients? Analysis of sign-out among internal medicine house staff , 2009, Quality & Safety in Health Care.

[13]  Jeremiah D Schuur,et al.  Dropping the baton: a qualitative analysis of failures during the transition from emergency department to inpatient care. , 2009, Annals of emergency medicine.

[14]  H. Thaler,et al.  Review of A Large Clinical Series: Intrahospital Transport of Critically Ill Patients: Outcomes, Timing, and Patterns , 2009, Journal of intensive care medicine.

[15]  Marianne Wallis,et al.  A literature review of organisational, individual and teamwork factors contributing to the ICU discharge process. , 2009, Australian critical care : official journal of the Confederation of Australian Critical Care Nurses.

[16]  M. Wallis,et al.  ICU patient's transfer anxiety: a prospective cohort study. , 2008, Australian critical care : official journal of the Confederation of Australian Critical Care Nurses.

[17]  Jeffrey B Cooper,et al.  Handoffs causing patient harm: a survey of medical and surgical house staff. , 2008, Joint Commission journal on quality and patient safety.

[18]  H. Wunsch,et al.  Variation in critical care services across North America and Western Europe* , 2008, Critical care medicine.

[19]  Tannaz Moin,et al.  Consequences of inadequate sign-out for patient care. , 2008, Archives of internal medicine.

[20]  Hardeep Singh,et al.  Medical errors involving trainees: a study of closed malpractice claims from 5 insurers. , 2007, Archives of internal medicine.

[21]  L. Mallak,et al.  Communicating in the "gray zone": perceptions about emergency physician hospitalist handoffs and patient safety. , 2007, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[22]  S. Kripalani,et al.  Promoting effective transitions of care at hospital discharge: a review of key issues for hospitalists. , 2007, Journal of hospital medicine.

[23]  S. Boutilier.  Leaving Critical Care: Facilitating a Smooth Transition , 2007, Dimensions of critical care nursing : DCCN.

[24]  N. Saufl.  2007 national patient safety goals. , 2007, Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses.

[25]  D. Baker,et al.  Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. , 2007, JAMA.

[26]  S. Millar,et al.  Don't fumble the handoff. Inpatient providers, specialists, and the primary care physician: a medical care delivery system with benefits and complex risks. , 2007, Journal of the Medical Association of Georgia.

[27]  Harlan M Krumholz,et al.  Transfers of patient care between house staff on internal medicine wards: a national survey. , 2006, Archives of internal medicine.

[28]  D. Berwick,et al.  The 100,000 lives campaign: setting a goal and a deadline for improving health care quality. , 2006, JAMA.

[29]  Kira Leeb,et al.  Intensive care in Canada. , 2006, Healthcare quarterly.

[30]  E. Zink.  Effect of a multidisciplinary intervention on communication and collaboration among physicians and nurses. , 2006, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[31]  K. Shojania,et al.  Graduate medical education and patient safety: a busy--and occasionally hazardous--intersection. , 2006, Annals of internal medicine.

[32]  Using medication reconciliation to prevent errors. , 2006, Sentinel event alert.

[33]  K. Shojania,et al.  National Patient Safety Goals. , 2006, Bulletin of the American College of Surgeons.

[34]  Richard M Frankel,et al.  Lost in Translation: Challenges and Opportunities in Physician-to-Physician Communication During Patient Handoffs , 2005, Academic medicine : journal of the Association of American Medical Colleges.

[35]  D. Meltzer,et al.  Communication failures in patient sign-out and suggestions for improvement: a critical incident analysis , 2005, Quality and Safety in Health Care.

[36]  M. Treggiari,et al.  A nationwide survey of intensive care unit discharge practices , 2005, Intensive Care Medicine.

[37]  R. J. Brown,et al.  A qualitative study of the experiences of patients following transfer from intensive care. , 2005, Intensive & critical care nursing.

[38]  H. Gardner,et al.  How do critical care nurses define the discharge planning process? , 2005, Intensive & critical care nursing.

[39]  H. Arksey,et al.  Scoping studies: towards a methodological framework , 2005 .

[40]  Sanjay Saint,et al.  Balancing Continuity of Care with Residents’ Limited Work Hours: Defining the Implications , 2005, Academic medicine : journal of the Association of American Medical Colleges.

[41]  A. Donabedian.  Evaluating the quality of medical care. 1966. , 1966, The Milbank quarterly.

[42]  S. Saint,et al.  Fumbled Handoffs: One Dropped Ball after Another Improving Patient Care , 2005 .

[43]  Robert A Berenson,et al.  Lost in Transition: Challenges and Opportunities for Improving the Quality of Transitional Care , 2004, Annals of Internal Medicine.

[44]  M. Courtney,et al.  Reducing family members' anxiety and uncertainty in illness around transfer from intensive care: an intervention study. , 2004, Intensive & critical care nursing.

[45]  José Orlando Gomes,et al.  Handoff strategies in settings with high consequences for failure: lessons for health care operations. , 2004, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[46]  K. Sutcliffe,et al.  Communication Failures: An Insidious Contributor to Medical Mishaps , 2004, Academic medicine : journal of the Association of American Medical Colleges.

[47]  Sharon Einav,et al.  Intensive care outflow limitation--frequency, etiology, and impact. , 2003, Journal of critical care.

[48]  Carnell Cooper,et al.  Daily multidisciplinary rounds shorten length of stay for trauma patients. , 2003, The Journal of trauma.

[49]  E. McGlynn.  Selecting Common Measures of Quality and System Performance , 2003, Medical care.

[50]  L. Aiken,et al.  Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. , 2002, JAMA.

[51]  K. McDonald,et al.  Making health care safer: a critical analysis of patient safety practices. , 2001, Evidence report/technology assessment.

[52]  K. Kizer.  The national quality forum , 2001 .

[53]  A. Rosenberg,et al.  Patients readmitted to ICUs* : a systematic review of risk factors and outcomes. , 2000, Chest.

[54]  N. Hoffart.  Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory , 2000 .

[55]  S Russell,et al.  Reducing readmissions to the intensive care unit. , 1999, Heart & lung : the journal of critical care.

[56]  D Landucci,et al.  The art and science of the handoff: how hospitalists share data. , 1998, The hospitalist.

[57]  D. Bates,et al.  Preventable adverse drug events in hospitalized patients: a comparative study of intensive care and general care units. , 1997, Critical care medicine.

[58]  E. Ackermann.  The Quality in Australian Health Care Study. , 1996, The Medical journal of Australia.

[59]  T. Brennan,et al.  Does Housestaff Discontinuity of Care Increase the Risk for Preventable Adverse Events? , 1994, Annals of Internal Medicine.

[60]  P Hollingsworth-Fridlund,et al.  An evaluation of provider-related and disease-related morbidity in a level I university trauma service: directions for quality improvement. , 1992, The Journal of trauma.

[61]  S. Shackford,et al.  The significance of critical care errors in causing preventable death in trauma patients in a trauma system. , 1991, The Journal of trauma.

[62]  T. Brennan,et al.  INCIDENCE OF ADVERSE EVENTS AND NEGLIGENCE IN HOSPITALIZED PATIENTS , 2008 .

[63]  T. Brennan,et al.  Incidence of adverse events and negligence in hospitalized patients. , 1991, The New England journal of medicine.

[64]  I A Mjör,et al.  Consensus Report , 1985, Journal of dental research.

[65]  K. Lohr,et al.  The Definition of Quality and Approaches to Its Assessment. , 1981 .

[66]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[67]  José Maria Paganni,et al.  Evaluating the quality of medical care. , 1966, The Milbank Memorial Fund quarterly.