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Barriers and facilitators to improve safety and efficiency of the ICU discharge process: a mixed methods study

Overview of attention for article published in BMC Health Services Research, April 2017
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Title
Barriers and facilitators to improve safety and efficiency of the ICU discharge process: a mixed methods study
Published in
BMC Health Services Research, April 2017
DOI 10.1186/s12913-017-2139-x
Pubmed ID
Authors

Nelleke van Sluisveld, Anke Oerlemans, Gert Westert, Johannes Gerardus van der Hoeven, Hub Wollersheim, Marieke Zegers

Abstract

Evidence 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. A 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). The 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%). Based 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.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 123 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 123 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 23 19%
Student > Master 17 14%
Student > Doctoral Student 12 10%
Other 9 7%
Researcher 8 7%
Other 23 19%
Unknown 31 25%
Readers by discipline Count As %
Nursing and Health Professions 57 46%
Medicine and Dentistry 18 15%
Pharmacology, Toxicology and Pharmaceutical Science 2 2%
Arts and Humanities 2 2%
Business, Management and Accounting 2 2%
Other 10 8%
Unknown 32 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 January 2018.
All research outputs
#9,927,394
of 12,400,381 outputs
Outputs from BMC Health Services Research
#3,424
of 4,104 outputs
Outputs of similar age
#196,212
of 267,592 outputs
Outputs of similar age from BMC Health Services Research
#4
of 4 outputs
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