Intensive care discharge summaries for general practice staff: a focus group study

Abstract

BackgroundUnderstanding how patients and relatives can be supported after hospital discharge is a UK research priority. Intensive Care Unit (ICU) discharge summaries are a simple way of providing GPs with the information they require to coordinate ongoing care, but little evidence is available to guide best practice.AimThis study aimed at better understanding the information needs of GP staff (GPs and practice nurses) supporting former patients of ICUs and their families following discharge from hospital, and identifying the barriers/facilitators associated with ICU–primary care information transfer.Design and settingThis was a qualitative exploratory study of practices and participants throughout the UK.MethodAudiotaped focus group discussions, complemented by small-group/individual interviews, were conducted with 15 former patients of ICUs, four relatives, and 20 GP staff between June and September 2015. Demographic data were captured by questionnaire and qualitative data were thematically analysed.ResultsFindings suggest variability in discharge information experiences and blurred lines of responsibility between hospital and GP staff, and patients/relatives. Continuity of care was affected by delayed or poor communication from the hospital; GPs’ limited contact with patients from critical care; and a lack of knowledge of the effects of critical illness or resources available to ameliorate these difficulties. Time pressures and information technology were, respectively, the most commonly mentioned barrier and facilitator.ConclusionEffective rehabilitation after a critical illness requires a coordinated and comprehensive approach, incorporating the provision of well-completed, timely, and relevant ICU–primary care discharge information. Health professionals need an improved understanding of critical illness, and patients and families must be included in all aspects of the information-sharing process.

Health problems among family caregivers of former intensive care unit (ICU) patients: an interview study

“…Together with ICU staff, GPs have ongoing opportunities to signal, monitor, and manage the health of both former ICU patients and their caregivers following ICU discharge. 27 – 29…”

A review of interventions supporting parent's psychological well‐being after a child's intensive care unit discharge

“…The provision of comprehensive, individualized, realistic and ideally flexible discharge plans with parents is needed, just like in the NICU setting (Purdy and Zeanah, ), to ensure a healthy transition. Discharge summaries with sufficient information to support primary care staff in managing the post‐PICU care of patients and their families would help ensure that staff are more aware of the events that occur in hospital and make them better equipped to deal with any future problems (Bench et al, ). This has also been identified as a goal for NICU follow‐up care where Purdy and Zeanah () refers to building bridges from NICU to the community by working together across health care teams to ensure appropriate mental health and psychosocial services are put in place before NICU discharge.…”

The nature and extent of service user involvement in critical care research and quality improvement: A scoping review of the literature

“…The review questions emerged from local work with critical care service users and service providers (Bench, Cornish, & Xyrichis, ; Bench, Day, & Griffiths, ; Goulding et al, ). These experiences identified a current lack of understanding around how best to involve former patients and their families and concerns regarding the impact of not doing it right.…”