Sydney Hyder MD, MS (is Pulmonary Disease and Critical Care Medicine Attending, Division of Pulmonary, Critical Care and Sleep Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago.), Ryan Tang MD (is Internal Medicine Resident, Northwestern University Feinberg School of Medicine.), Reiping Huang PhD, MS (is Health Services Research and Adjunct Assistant Professor, Department of Surgery, Northwestern University Feinberg School of Medicine.), Amy Ludwig MD (is Clinical Fellow, Pulmonary Disease and Critical Care Medicine, Northwestern University Feinberg School of Medicine.), Kelli Scott PhD (is Assistant Professor of Medical Social Sciences, Center for Dissemination & Implementation Science, Northwestern University Feinberg School of Medicine.), Nandita Nadig MD, MS (is Associate Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine. Please address correspondence to Sydney Hyder)
{"title":"针对重症监护室间转运过程中等待时间延长问题实施跨学科转运集合干预措施","authors":"Sydney Hyder MD, MS (is Pulmonary Disease and Critical Care Medicine Attending, Division of Pulmonary, Critical Care and Sleep Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago.), Ryan Tang MD (is Internal Medicine Resident, Northwestern University Feinberg School of Medicine.), Reiping Huang PhD, MS (is Health Services Research and Adjunct Assistant Professor, Department of Surgery, Northwestern University Feinberg School of Medicine.), Amy Ludwig MD (is Clinical Fellow, Pulmonary Disease and Critical Care Medicine, Northwestern University Feinberg School of Medicine.), Kelli Scott PhD (is Assistant Professor of Medical Social Sciences, Center for Dissemination & Implementation Science, Northwestern University Feinberg School of Medicine.), Nandita Nadig MD, MS (is Associate Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine. Please address correspondence to Sydney Hyder)","doi":"10.1016/j.jcjq.2024.01.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>ICU transfers from a regional to a tertiary-level hospital are initiated typically for a higher level of care. Extended transfer wait times can negatively affect survival, length of stay (LOS), and cost.</p></div><div><h3>Methods</h3><p>In this prospective single-center study, the subjects were adult ICU patients admitted to regional hospitals between January and October 2022, for whom a request was made to transfer to a tertiary-level medical ICU. The authors developed and implemented an interdisciplinary transfer huddle intervention (THI) with the goal of reducing wait times by providing a consistent channel of communication between key stakeholders. The primary outcome was the number of hours elapsed between transfer request and the time of transfer to the tertiary hospital. Secondary outcomes included in-hospital mortality, discharge to home, ICU LOS, and hospital LOS. Data were abstracted from electronic health records and periods before (January to June 2022) and after (June to October 2022) the intervention were compared. Data were analyzed using logistic regression or negative binomial regression, adjusting for patient demographic and clinical characteristics. ICU fellows also completed a daily survey about barriers they perceived to the THI application.</p></div><div><h3>Results</h3><p>During the study period, 76 patients were transferred. The THI was completed 75.0% of the time. There were no statistically significant differences in the primary and secondary outcomes before and after the intervention. The top perceived barriers to transfer were lack of physical beds (50.0%) and staffing limitations (37.5%).</p></div><div><h3>Conclusion</h3><p>The authors successfully developed and implemented a transfer huddle to ensure consistent interdisciplinary communication for patients being transferred between ICUs and identified barriers to such transfer. However, transfer times and patient outcomes were not significantly different after the change. Future studies should consider staffing challenges, hospital capacity, and the role of dedicated transfer teams in in decreasing inter-ICU transfer wait times.</p></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Implementation of an Interdisciplinary Transfer Huddle Intervention for Prolonged Wait Times During Inter-ICU Transfer\",\"authors\":\"Sydney Hyder MD, MS (is Pulmonary Disease and Critical Care Medicine Attending, Division of Pulmonary, Critical Care and Sleep Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago.), Ryan Tang MD (is Internal Medicine Resident, Northwestern University Feinberg School of Medicine.), Reiping Huang PhD, MS (is Health Services Research and Adjunct Assistant Professor, Department of Surgery, Northwestern University Feinberg School of Medicine.), Amy Ludwig MD (is Clinical Fellow, Pulmonary Disease and Critical Care Medicine, Northwestern University Feinberg School of Medicine.), Kelli Scott PhD (is Assistant Professor of Medical Social Sciences, Center for Dissemination & Implementation Science, Northwestern University Feinberg School of Medicine.), Nandita Nadig MD, MS (is Associate Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine. Please address correspondence to Sydney Hyder)\",\"doi\":\"10.1016/j.jcjq.2024.01.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>ICU transfers from a regional to a tertiary-level hospital are initiated typically for a higher level of care. Extended transfer wait times can negatively affect survival, length of stay (LOS), and cost.</p></div><div><h3>Methods</h3><p>In this prospective single-center study, the subjects were adult ICU patients admitted to regional hospitals between January and October 2022, for whom a request was made to transfer to a tertiary-level medical ICU. The authors developed and implemented an interdisciplinary transfer huddle intervention (THI) with the goal of reducing wait times by providing a consistent channel of communication between key stakeholders. The primary outcome was the number of hours elapsed between transfer request and the time of transfer to the tertiary hospital. Secondary outcomes included in-hospital mortality, discharge to home, ICU LOS, and hospital LOS. Data were abstracted from electronic health records and periods before (January to June 2022) and after (June to October 2022) the intervention were compared. Data were analyzed using logistic regression or negative binomial regression, adjusting for patient demographic and clinical characteristics. ICU fellows also completed a daily survey about barriers they perceived to the THI application.</p></div><div><h3>Results</h3><p>During the study period, 76 patients were transferred. The THI was completed 75.0% of the time. There were no statistically significant differences in the primary and secondary outcomes before and after the intervention. The top perceived barriers to transfer were lack of physical beds (50.0%) and staffing limitations (37.5%).</p></div><div><h3>Conclusion</h3><p>The authors successfully developed and implemented a transfer huddle to ensure consistent interdisciplinary communication for patients being transferred between ICUs and identified barriers to such transfer. However, transfer times and patient outcomes were not significantly different after the change. Future studies should consider staffing challenges, hospital capacity, and the role of dedicated transfer teams in in decreasing inter-ICU transfer wait times.</p></div>\",\"PeriodicalId\":14835,\"journal\":{\"name\":\"Joint Commission journal on quality and patient safety\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-01-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Joint Commission journal on quality and patient safety\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1553725024000382\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Joint Commission journal on quality and patient safety","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1553725024000382","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Implementation of an Interdisciplinary Transfer Huddle Intervention for Prolonged Wait Times During Inter-ICU Transfer
Background
ICU transfers from a regional to a tertiary-level hospital are initiated typically for a higher level of care. Extended transfer wait times can negatively affect survival, length of stay (LOS), and cost.
Methods
In this prospective single-center study, the subjects were adult ICU patients admitted to regional hospitals between January and October 2022, for whom a request was made to transfer to a tertiary-level medical ICU. The authors developed and implemented an interdisciplinary transfer huddle intervention (THI) with the goal of reducing wait times by providing a consistent channel of communication between key stakeholders. The primary outcome was the number of hours elapsed between transfer request and the time of transfer to the tertiary hospital. Secondary outcomes included in-hospital mortality, discharge to home, ICU LOS, and hospital LOS. Data were abstracted from electronic health records and periods before (January to June 2022) and after (June to October 2022) the intervention were compared. Data were analyzed using logistic regression or negative binomial regression, adjusting for patient demographic and clinical characteristics. ICU fellows also completed a daily survey about barriers they perceived to the THI application.
Results
During the study period, 76 patients were transferred. The THI was completed 75.0% of the time. There were no statistically significant differences in the primary and secondary outcomes before and after the intervention. The top perceived barriers to transfer were lack of physical beds (50.0%) and staffing limitations (37.5%).
Conclusion
The authors successfully developed and implemented a transfer huddle to ensure consistent interdisciplinary communication for patients being transferred between ICUs and identified barriers to such transfer. However, transfer times and patient outcomes were not significantly different after the change. Future studies should consider staffing challenges, hospital capacity, and the role of dedicated transfer teams in in decreasing inter-ICU transfer wait times.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
