SHM Converge Scientific Abstract ePoster Gallery-Perceptions of the Transition of Care for Icu Patients

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This study examined how hospitalist physicians and advanced practice practitioners (APPs) perceive the transition of care for patients moving from the medical ICU to the ward at a large urban academic hospital. The authors noted that ICU-to-ward transfers are a high-risk period due to patient acuity, changes in location, lower resource availability, and the possibility of premature discharge or readmission.<br /><br />To assess concerns and opportunities for improvement, the team created a 26-question anonymous survey covering two main areas: (1) appropriateness of triage and readiness for transfer, and (2) handoffs. The survey was emailed in July 2021 to clinically active hospitalists and APPs at UChicago Medicine. Of 60 eligible providers, 37 responded, for a 62% response rate.<br /><br />Key findings showed that 69% of physicians felt comfortable triaging ICU transfer patients, and all respondents believed the triage physician should have input into accepting ICU transfers. The most common suggestion for improvement was standardizing transfer criteria. Regarding readiness, many respondents felt that some patients were still unstable at transfer: 42% estimated 5–10% of ICU transfers were unstable, and about 25% thought 10–20% were unstable. When instability was noted, most would speak with the ICU resident, but only 11% would contact the ICU attending.<br /><br />For handoffs, 66% felt resident transfer notes were comprehensive, though opinions were mixed on whether they were concise or too wordy. Most respondents (80%) wanted verbal sign-out in addition to written handoff. Other concerns included order reconciliation and undocumented code status.<br /><br />Overall, the main concern was uncertainty about patient stability and readiness for transfer, while handoffs were generally viewed as adequate. The authors conclude that clearer criteria for ICU transfer readiness are needed.

Asset Subtitle

Khanh T. Nguyen

Meta Tag

Author List David Pavkovich, Elizabeth A. Murphy, Ethan Molitch-HoU, Felicia R. d'Souza, Khanh T. Nguyen, Maya Viner, Sandeep Tummala

Category Research

Concept ICU-to-Ward Transition

Concept Readiness for Transfer

Concept Patient Stability

Concept Handoff Note

Concept Verbal Handoff

Distinguished Non-Finalist

Presenter Organization University of Chicago

Presenting Author Khanh T. Nguyen

Track Transitions of Care

Keywords

ICU-to-ward transfer

hospitalist physicians

advanced practice practitioners

patient readiness

transfer triage

handoffs

patient stability

transfer criteria

verbal sign-out

order reconciliation

ICU-to-Ward Transition

Readiness for Transfer

Patient Stability

Handoff Note

Verbal Handoff