A multidisciplinary initiative to standardize intensive care to acute care transitions

Halvorson, Stephanie; Wheeler, Brian; Willis, Marge; Watters, Jennifer M.; Eastman, Jamie; O’Donnell, Randy; Merkel, Matthias

doi:10.1093/intqhc/mzw076

Cited by 25 publications

(20 citation statements)

References 33 publications

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“…These communication problems are more common in the transition hand-off between two places when the responsibility of the patient shifts between the members of the care team [ 36 ] and if the communication method is not clear and consistent. A basic analysis of these failures showed that the lack of a standard protocol for transition from the ICU to a ward is a contributing factor to the potential risks of harm to the patient [ 37 ]. In this study, the findings indicate that ineffective communication is one of the challenges of the patient transition process from the ICU.…”

Section: Discussionmentioning

confidence: 99%

Challenges of the patient transition process from the intensive care unit: a qualitative study

et al. 2021

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Background:The transition of patients from the intensive care unit (ICU) to the general ward is challenging. Patients and caregivers experience high levels of anxiety during the transition period.This study aimed to explain the challenges that patients face during the transition process. Methods:In this qualitative research of conventional content analysis, data collection was conducted between February 2018 and July 2019 in educational hospitals affiliated with the Iran University of Medical Sciences. After obtaining informed consent, purposive sampling was performed with 22 nurses, intensive care physicians, anesthesiologists, and patients and their families using in-depth semi-structured interviews until data saturation. Results:The data obtained from the interviews indicated their perceptions and experiences, which are expressed scientifically through qualitative research. A total of 504 initial codes were extracted from continuous data analysis. The content analysis yielded three main themes in the challenges patients face during the transition process from the ICU: mixed feelings regarding transition (happiness/hope, worry/uncertainty, abandonment); care break (different atmosphere, the difference between the program and the quality of care, assigning care to the patient and family, and care culture and beliefs); and search for support and information (ineffective communication, self-care capacity of patient and family, ineffective and disrupted training, and weak follow-up programs), which inflicts care shock in the patients. Conclusions:The results showed that patients and their families were in a state of care shock during the ICU transition process and were sometimes disconcerted. It is necessary to design and implement care models according to the needs and challenges patients face during the transition period from ICU (patient-centered), based on the evidence available, and after considering the field of medicine and the accessibility of care in the country. The transition process can be improved and enhanced by obtaining knowledge about ICU transition care and related challenges as well as organizing a learning environment.

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Section: Discussionmentioning

confidence: 99%

Challenges of the patient transition process from the intensive care unit: a qualitative study

et al. 2021

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“…Early involvement of stakeholders is important (Halvorson et al, 2016;Parenmark et al, 2019) and involving families of patients can be one way of managing the consensus of diverse stakeholder groups when prioritizing quality improvement suggestions. In a study by McKenzie et al (2017), nine individuals were selected, representing providers, decision makers and patients' families from ICUs within a single geographically defined healthcare system, forming a panel for assessing and reconciling priorities for improving the care of critically ill patients.…”

Section: Resultsmentioning

confidence: 99%

“…Standardizing the patient transfer process is often discussed as a way of improving the patient transfer process (Alali et al, 2019;Halvorson et al, 2016). Lee et al (2019) presented a Improving ICU transitional care queuing network model to study patient transitions.…”

Section: Resultsmentioning

confidence: 99%

Improving ICU transitional care by combining quality management and nursing science – two scientific fields meet in a systematic literature review

Sten

Ingelsson

Bäckström

et al. 2020

IJQSS

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Purpose The purpose of this literature review was to explore to what extent quality management (QM) and nursing science offer complementary perspectives to provide better quality care, by looking at QM core concepts and tools. Design/methodology/approach A systematic literature review was conducted. Papers published in academic journals between January 2013 and December 2019 were included. A deductive content analysis was chosen using QM core values as an analytical framework. Findings The results showed that QM core values, methodologies and tools were found in the reviewed articles about intensive care unit (ICU) transitional care. The results indicated that core values in QM and the core competencies within nursing science in ICU transitional care are mutually dependent upon each other and exist as a whole. ICU transitional care is, however, a complex interpersonal process, characterized by differences in organizational cultures and core values and involving multidisciplinary teams that collaborate across hospital units. The QM core value that was least observed was committed leadership. Research limitations/implications Combining QM and nursing science can contribute to a deeper understanding of how to improve the ICU transitional care process by bringing complementary perspectives. Practical implications The included articles portray how QM is applied in ICU transitional care. Implications for future research focus on enhancing the understanding of how QM and nursing science can bring complementary perspectives in order to improve ICU transitional care and how QM values, methodologies and tools can be used in ICU transitional care. Committed leadership and team collaboration in ICU transitional care are areas that call for further research. Originality/value The findings contribute to the body of literature by providing important insights in terms of how QM core values, methodologies and tools are present in research about ICU transitional care and how the two research subjects, namely, QM and nursing science, bring complementary perspectives.

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“…While it is critical to understand the risks posed to patients during transfers, the impact of transfers on hospital staff from a wide array of professional backgrounds is less well-understood (Halvorson et al, 2016;Rosenberg et al, 2018). Research that acknowledges staff experiences in maintaining patient safety during intra-hospital transfers is needed to understand other factors that contribute to adverse events, delays in care and other risks to patients (Hearld, Alexander, Fraser, & Jiang, 2008).…”

Section: Introductionmentioning

confidence: 99%

Cooperation and conflict in intra‐hospital transfers: A qualitative analysis

et al. 2019

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Aim The purpose of this study was to explore the latent conditions of cooperation and conflict in intra‐hospital patient transfers (i.e. transfers of patients between units in a hospital). Design Secondary qualitative analysis of 28 interviews conducted with 29 hospital staff, including physicians (N = 13), nurses (N = 10) and support staff (N = 6) from a single, large academic tertiary hospital in the Northeastern United States. Methods A two‐member multidisciplinary team applied a directed content analysis approach to data collected from semi‐structured interviews. Results Three recurrent themes were generated: (a) patient flow policies created imbalances of power; (b) relationships were helpful to facilitate safe transfers; and (c) method of admission order communication was a source of disagreement. Hospital quality improvement efforts could benefit from a teaming approach to minimize unintentional power imbalances and optimize communicative relationships between units.

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A multidisciplinary initiative to standardize intensive care to acute care transitions

Cited by 25 publications

References 33 publications

Challenges of the patient transition process from the intensive care unit: a qualitative study

Challenges of the patient transition process from the intensive care unit: a qualitative study

Improving ICU transitional care by combining quality management and nursing science – two scientific fields meet in a systematic literature review

Cooperation and conflict in intra‐hospital transfers: A qualitative analysis

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