Structured handoff checklists improve clinical measures in patients discharged from the neurointensive care unit

Coon, Elizabeth A.; Kramer, Neha M.; Fabris, Rachel R.; Burkholder, David B.; Klaas, James P.; Graff‐Radford, Jonathan; Moore, Scott Emory; Wijdicks, Eelco F. M.; Britton, Jeffrey W.; Jones, Lyell K.

doi:10.1212/cpj.0000000000000094

Cited by 17 publications

(32 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, several practices are identified as potential tools to improve the quality of transition of care and patient safety. One of the practices suggested is the adoption of a transfer checklist with items to check whether the patient is ready and the necessary adjustments before discharge, such as removal of invasive devices and medication reconciliation ( 23 , 26 ) . The oral or written communication was analyzed by several studies in different aspects.…”

Section: Resultsmentioning

confidence: 99%

“…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%

“…The readmission ( 13 - 14 , 20 , 26 , 31 - 32 , 34 - 35 , 43 , 46 - 47 , 49 - 52 ) and death ( 13 - 14 , 19 - 20 , 31 - 35 , 39 , 43 , 46 , 49 , 51 - 52 ) outcomes were more analyzed in the studies than other outcomes, with mortality rates showing a wide variation (3-30%) ( 19 , 46 ) . Few studies were devoted to assessing other adverse outcomes; however, it is important to note that not all patients undergoing an inadequate transition process evolve to death or readmission but, even so, they may be subjected to unwanted repercussions with serious consequences, such as the need to change or increase the length of treatment, increased length of hospital stay, disabilities, increased hospital costs, and dissatisfaction ( 9 ) .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

Hervé

Zucatti

Lima

2020

Rev. Latino-Am. Enfermagem

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Hervé

Zucatti

Lima

2020

Rev. Latino-Am. Enfermagem

View full text Add to dashboard Cite

show abstract

“…This is among the highest rates of handoff tool utilization reported in studies of transfer optimization (45%-94%). 1,6,15 We hypothesize that the high level of utilization was achieved through engagement of key stakeholders, including residents and APPs, in the development and implementation process and the ease of use of the checklist. The checklist did not create an additional opportunity cost in the form of a new documentation task.…”

Section: Discussionmentioning

confidence: 99%

“…One previous study examined the impact of a handoff checklist at the time of transfer from the ICU to the hospital ward in the neurocritical care population. 15 The checklist was associated with improved medication reconciliation and discontinuation of urinary catheters and had no effect on ICU or hospital length of stay (LOS).…”

Section: Introductionmentioning

confidence: 99%

A Standardized Checklist Improves the Transfer of Stroke Patients from the Neurocritical Care Unit to Hospital Ward

Murray

Joshi

Kronfeld

et al. 2019

The Neurohospitalist

View full text Add to dashboard Cite

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.

show abstract