ArticleBMC health services research2017
Barriers and facilitators to improve safety and efficiency of the ICU discharge process: a mixed methods study.
Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Medication-related interventions to improve medication safety and patient outcomes on transition from adult intensive care settings: a systematic review and meta-analysis.BMJ quality & safety · 2022Pooled it
- Implementation and feasibility evaluation of a standard set of intensive care unit discharge criteria in a prospective before-after observational pilot study.BMC health services research · 2026Observational
- Nurses' Experiences of Interprofessional Collaboration in Digitally Supported Hospital Discharge Planning: Qualitative Study.JMIR nursing · 2026Article
- Article
- Exploring timely and safe discharge from ICU: a comparative study of machine learning predictions and clinical practices.Intensive care medicine experimental · 2025Article
- Transition experiences of patients and families upon discharge from intensive care: a scoping review.Revista latino-americana de enfermagem · 2025Article
- Improving medication safety for intensive care patients transitioning to a hospital ward: development of a theory-informed intervention package.BMC health services research · 2024Article
- Ethical considerations in evaluating discharge readiness from the intensive care unit.Nursing ethics · 2024Article
- The current state of intensive care unit discharge practices - Results of an international survey study.Frontiers in medicine · 2024Article
- Patient transfer from intensive care units to general wards: An exploratory qualitative study of ward nurses' experiences of patient safety.Nursing open · 2023Article
- Organizational attributes that contribute to the learning & improvement capabilities of healthcare organizations: a scoping review.BMC health services research · 2023Article
- Article
- Improving Communication in Intensive Care Unit to Ward Transitions: Protocol for Multisite National Implementation of the ICU-PAUSE Handoff Tool.JMIR research protocols · 2023Article
- Delphi study to derive expert consensus on a set of criteria to evaluate discharge readiness for adult ICU patients to be discharged to a general ward-European perspective.BMC health services research · 2022Article
- Determining the skills needed by frontline NHS staff to deliver quality improvement: findings from six case studies.BMJ quality & safety · 2022Article
- Factors Influencing the Decision-making of Healthcare Providers Regarding the Transition of Patients from the Intensive Care Unit to the General Ward in Iran: A Qualitative Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Voluntarily reported prescribing, monitoring and medication transfer errors in intensive care units in The Netherlands.International journal of clinical pharmacy · 2021Article
- Outcomes of critically ill end-stage kidney disease patients who underwent major surgery.PeerJ · 2021Article
- Reducing work pressure and IT problems and facilitating IT integration and audit & feedback help adherence to perioperative safety guidelines: a survey among 95 perioperative professionals.Implementation science communications · 2020Article
- Transition of care at discharge from the Intensive Care Unit: a scoping review.Revista latino-americana de enfermagem · 2020Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence indicates that suboptimal clinical handover from the intensive care unit (ICU) to general wards leads to unnecessary ICU readmissions and increased mortality. We aimed to gain insight into barriers and facilitators to implement and use ICU discharge practices.
methodsA mixed methods approach was conducted, using 1) 23 individual and four focus group interviews, with post-ICU patients, ICU managers, and nurses and physicians working in the ICU or general ward of ten Dutch hospitals, and 2) a questionnaire survey, which contained 27 statements derived from the interviews, and was completed by 166 ICU physicians (21.8%) from 64 Dutch hospitals (71.1% of the total of 90 Dutch hospitals).
resultsThe interviews resulted in 66 barriers and facilitators related to: the intervention (e.g., feasibility); the professional (e.g., attitude towards checklists); social factors (e.g., presence or absence of a culture of feedback); and the organisation (e.g., financial resources). A facilitator considered important by ICU physicians was a checklist to structure discharge communication (92.2%). Barriers deemed important were lack of a culture of feedback (55.4%), an absence of discharge criteria (23.5%), and an overestimation of the capabilities of general wards to care for complex patients by ICU physicians (74.7%).
conclusionsBased on the barriers and facilitators found in this study, improving handover communication, formulating specific discharge criteria, stimulating a culture of feedback, and preventing overestimation of the general ward are important to effectively improve the ICU discharge process.
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