Katherine G Hicks, Lois Downey, Addy Elketami, Elizabeth L Nielsen, Ruth A Engelberg, Ann L Jennerich
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Before-After Study of a Checklist to Improve Acute Care to ICU Handoffs.
Transferring care of a patient is a critical process. The objective of this study was to evaluate a checklist to standardize handoffs from acute care to the intensive care unit (ICU). This was a single-center, before-after study of a checklist to standardize transfers of patients from acute care to the medical-cardiac ICU. Clinicians completed surveys about handoffs before and after checklist implementation. The association between study period and survey data was analyzed using multivariable logistic regression with cross-classified multilevel models. Surveys were completed by 179 clinicians. After checklist implementation, handoffs were more likely to occur in the ICU (OR 17.23; 95% CI, 1.81-164.19) and cover patient treatment preferences (OR 2.73; 95% CI, 1.12-6.66). However, checklist uptake was suboptimal (30% of responses indicated checklist use). Implementation of a checklist during acute care to ICU transfers is challenging. Signals suggesting process improvement warrant additional study.
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The American Journal of Medical Quality (AJMQ) is focused on keeping readers informed of the resources, processes, and perspectives contributing to quality health care services. This peer-reviewed journal presents a forum for the exchange of ideas, strategies, and methods in improving the delivery and management of health care.
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