Development and implementation of a risk identification tool to facilitate critical care transitions for high-risk surgical patients

Hoffman, Rebecca L.; Saucier, Jason; Dasani, Serena; Collins, Tara; Holena, Daniel N.; Fitzpatrick, Meghan; Tsypenyuk, Boris; Martin, Niels D.

doi:10.1093/intqhc/mzx032

Cited by 19 publications

(36 citation statements)

References 32 publications

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“…Readmission affects 4.1% ( 51 ) to 9.2% ( 46 ) of the patients in any period of hospitalization, 2.9% ( 14 ) in 48 hours after the transfer and 2.7% ( 32 ) to 4.2% ( 13 ) within 72 hours. Other clinical outcomes analyzed are length of hospital stay ( 31 - 32 , 35 , 39 - 40 , 49 ) , care provided by a Rapid Response Team (RRT) ( 26 , 43 ) , cardiac arrest ( 47 ) , and medications-related problems ( 49 ) . Outcomes such as anxiety, stress, and satisfaction of patients and families also appear in the studies ( 24 , 28 , 30 , 44 , 48 ) .…”

Section: Resultsmentioning

confidence: 99%

Transition of care at discharge from the Intensive Care Unit: a scoping review

Hervé

Zucatti

Lima

2020

Rev. Latino-Am. Enfermagem

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Objective: to map the available evidence on the components of the transition of care, practices, strategies, and tools used in the discharge from the Intensive Care Unit (ICU) to the Inpatient Unit (IU) and its impact on the outcomes of adult patients. Method: a scoping review using search strategies in six relevant health databases. Results: 37 articles were included, in which 30 practices, strategies or tools were identified for organizing and executing the transfer process, with positive or negative impacts, related to factors intrinsic to the Intensive Care Unit and the Inpatient Unit and cross-sectional factors regarding the staff. The analysis of hospital readmission and mortality outcomes was prevalent in the included studies, in which trends and potential protective actions for a successful care transition are found; however, they still lack more robust evidence and consensus in the literature. Conclusion: transition of care components and practices were identified, in addition to factors intrinsic to the patient, associated with worse outcomes after discharge from the Intensive Care Unit. Discharges at night or on weekends were associated with increased rates of readmission and mortality; however, the association of other practices with the patient’s outcome is still inconclusive.

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Section: Resultsmentioning

confidence: 99%

Transition of care at discharge from the Intensive Care Unit: a scoping review

Hervé

Zucatti

Lima

2020

Rev. Latino-Am. Enfermagem

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“…Before the beginning of the QI intervention, significant focus on the education of ward staff about acutely deteriorating patients took place. Standardized communications tools, such as the Situation Background Assessment Recommendation (SBAR); reporting; and defined risk stratification tools based on the NEWS were deployed, as recommended previously (Hoffman et al, ).…”

Section: Methodsmentioning

confidence: 99%

Improving outcome of sepsis on the ward: introducing the ‘Sepsis Six’ bundle

Burke

Wood

Hermon

et al. 2018

Nursing in Critical Care

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“…There is increasing recognition of the need to quantify longer term outcomes for patients after critical care admission. Critical care survivors suffer continued and significant healthcare burden, (1-3) and decreased longer-term survival compared to the general population (4,5). Such tools could be used to guide interventions to improve outcomes for at-risk patients (6).…”

Section: Introductionmentioning

confidence: 99%

“…Critical care scoring systems frequently focus on outcome prediction for the hospital admission episode rather than long-term survival (2,(8)(9)(10). Further, these tools can be complex and labour intensive (5,11), with variable discriminative ability (12). The Sabadell Score was developed and validated as a simplified tool based on the judgement of the attending critical care physician to predict the likelihood of in-hospital mortality after critical care discharge (13,14).…”

Section: Introductionmentioning

confidence: 99%

The Sabadell score is an independent predictor of five-year outcome after critical care discharge

Morton

Penston

McHale

et al. 2019

Preprint

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Background: Critical care survivors frequently suffer persistent morbidity and increased risk of mortality compared to the general population. However, there are no standardised tools to identify at-risk patients to target potential interventions. Our aim was to establish whether the “Sabadell score”, a simple tool applied upon critical care discharge, is an independent predictor of five-year mortality.Methods: Prospective observational cohort study of adults admitted to a mixed critical care unit at Aintree University Hospital NHS Foundation Trust, Liverpool, United Kingdom. Sabadell score applied to all patients from September 2011 to December 2017. Primary outcome: five-year mortality assessed using a multivariable flexible parametric survival analysis adjusted for demographics, and clinically relevant covariates. Primary outcome: Adults discharged alive following critical care admission. Results: There were 5954 patients with a minimum of 18 months follow-up. Mean age was 59.5 (SD±17) and 57.1% were male. Patients were categorised into Sabadell scores, zero (38.4%), one (47.9%), two (10.5%) and three (3.1%). Adjusted hazard ratios for mortality were 2.09 (C.I. 1.85–2.36), 3.95 (C.I. 3.39–4.60) and 21.04 (C.I. 17.24–25.68) respectively. Sabadell score three predicted 99.9%, 99.5%, 98.5% and 87.4% mortality at five years for patients ³80 (aHR 3.37), 60-79 (aHR 2.52), 40-59 (aHR 2.03) and 16-39 respectively. A Sabadell score of two predicted 71.0%, 52.7%, 44.8% and 23.7% mortality at five years for these age categories.Conclusions : Sabadell score is an independent predictor of five-year survival after critical care discharge. These findings could be used to guide provision of increased support for patients after critical care discharge and/or informed discussions with patients and relatives about dying to ascertain their future wishes.

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Development and implementation of a risk identification tool to facilitate critical care transitions for high-risk surgical patients

Abstract: The implementation of this ICU transition protocol is feasible and internationally applicable, and results in improved care coordination and communication for a high-risk group of patients.

Cited by 19 publications

References 32 publications

Transition of care at discharge from the Intensive Care Unit: a scoping review

Transition of care at discharge from the Intensive Care Unit: a scoping review

Improving outcome of sepsis on the ward: introducing the ‘Sepsis Six’ bundle

The Sabadell score is an independent predictor of five-year outcome after critical care discharge

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