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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.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 136 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 136 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 25 18%
Student > Master 17 13%
Student > Doctoral Student 12 9%
Other 11 8%
Student > Postgraduate 8 6%
Other 23 17%
Unknown 40 29%
Readers by discipline Count As %
Nursing and Health Professions 59 43%
Medicine and Dentistry 19 14%
Arts and Humanities 3 2%
Pharmacology, Toxicology and Pharmaceutical Science 2 1%
Business, Management and Accounting 2 1%
Other 10 7%
Unknown 41 30%
Attention Score in Context

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
#18,567,744
of 22,997,544 outputs
Outputs from BMC Health Services Research
#6,541
of 7,702 outputs
Outputs of similar age
#235,090
of 309,006 outputs
Outputs of similar age from BMC Health Services Research
#121
of 140 outputs
Altmetric has tracked 22,997,544 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
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