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Reducing unnecessary delays during the transfer of patients from the paediatric intensive care unit to the general ward: a quality improvement project
INTRODUCTION: Delaying the discharge of paediatric intensive care unit (PICU) patients is directly proportional to increased occupancy rate and cost. We aimed to study the process of transferring patients from the PICU to the general ward in order to improve the timeliness of this process while guar...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6730600/ https://www.ncbi.nlm.nih.gov/pubmed/31544165 http://dx.doi.org/10.1136/bmjoq-2019-000695 |
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author | Alali, Hamza Kazzaz, Yasser Alshehri, Ali Antar, Mohannad Alhamouieh, Ousaima Hasan, Zahra Al-Surimi, Khaled |
author_facet | Alali, Hamza Kazzaz, Yasser Alshehri, Ali Antar, Mohannad Alhamouieh, Ousaima Hasan, Zahra Al-Surimi, Khaled |
author_sort | Alali, Hamza |
collection | PubMed |
description | INTRODUCTION: Delaying the discharge of paediatric intensive care unit (PICU) patients is directly proportional to increased occupancy rate and cost. We aimed to study the process of transferring patients from the PICU to the general ward in order to improve the timeliness of this process while guaranteeing patient safety. METHODS: A multidisciplinary quality improvement (QI) team was formed to analyse the transfer process. Several Plan Do Study Act cycles were tested, targeting all steps of the transfer process, and applying turnaround time (TAT)—the duration from the time of clinical transfer decision until the physical transfer of the patient—as an outcome measure, aiming for a TAT of 4 hours. RESULTS: Baseline results showed that medical transfer decisions by PICU attending physicians were taken late for most patients: only 19% of decisions were made by 08:00 by the on-call team. Average TAT of the transfer process was over 7 hours, with duration ranging from 7 to 17 hours. After implementing all suggested improvement interventions, early decision compliance improved to 59%. TAT improved gradually, starting in January 2017, until it approached our target (284–261 min≈4 hours) in February–May 2017. CONCLUSION: PICU patient transfer process delays can be reduced by early evaluation, timely team communication and proper preparation. It is recommended that all personnel with early involvement avoid unnecessary delays by paying more attention to all process steps, starting with the clinical decision, until the physical transfer. Standardising transfer processes might lead to a decrease in the length of PICU stay, which is a desirable outcome, but this observation needs further exploration. |
format | Online Article Text |
id | pubmed-6730600 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-67306002019-09-20 Reducing unnecessary delays during the transfer of patients from the paediatric intensive care unit to the general ward: a quality improvement project Alali, Hamza Kazzaz, Yasser Alshehri, Ali Antar, Mohannad Alhamouieh, Ousaima Hasan, Zahra Al-Surimi, Khaled BMJ Open Qual Quality Improvement Programme INTRODUCTION: Delaying the discharge of paediatric intensive care unit (PICU) patients is directly proportional to increased occupancy rate and cost. We aimed to study the process of transferring patients from the PICU to the general ward in order to improve the timeliness of this process while guaranteeing patient safety. METHODS: A multidisciplinary quality improvement (QI) team was formed to analyse the transfer process. Several Plan Do Study Act cycles were tested, targeting all steps of the transfer process, and applying turnaround time (TAT)—the duration from the time of clinical transfer decision until the physical transfer of the patient—as an outcome measure, aiming for a TAT of 4 hours. RESULTS: Baseline results showed that medical transfer decisions by PICU attending physicians were taken late for most patients: only 19% of decisions were made by 08:00 by the on-call team. Average TAT of the transfer process was over 7 hours, with duration ranging from 7 to 17 hours. After implementing all suggested improvement interventions, early decision compliance improved to 59%. TAT improved gradually, starting in January 2017, until it approached our target (284–261 min≈4 hours) in February–May 2017. CONCLUSION: PICU patient transfer process delays can be reduced by early evaluation, timely team communication and proper preparation. It is recommended that all personnel with early involvement avoid unnecessary delays by paying more attention to all process steps, starting with the clinical decision, until the physical transfer. Standardising transfer processes might lead to a decrease in the length of PICU stay, which is a desirable outcome, but this observation needs further exploration. BMJ Publishing Group 2019-09-04 /pmc/articles/PMC6730600/ /pubmed/31544165 http://dx.doi.org/10.1136/bmjoq-2019-000695 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Quality Improvement Programme Alali, Hamza Kazzaz, Yasser Alshehri, Ali Antar, Mohannad Alhamouieh, Ousaima Hasan, Zahra Al-Surimi, Khaled Reducing unnecessary delays during the transfer of patients from the paediatric intensive care unit to the general ward: a quality improvement project |
title | Reducing unnecessary delays during the transfer of patients from the paediatric intensive care unit to the general ward: a quality improvement project |
title_full | Reducing unnecessary delays during the transfer of patients from the paediatric intensive care unit to the general ward: a quality improvement project |
title_fullStr | Reducing unnecessary delays during the transfer of patients from the paediatric intensive care unit to the general ward: a quality improvement project |
title_full_unstemmed | Reducing unnecessary delays during the transfer of patients from the paediatric intensive care unit to the general ward: a quality improvement project |
title_short | Reducing unnecessary delays during the transfer of patients from the paediatric intensive care unit to the general ward: a quality improvement project |
title_sort | reducing unnecessary delays during the transfer of patients from the paediatric intensive care unit to the general ward: a quality improvement project |
topic | Quality Improvement Programme |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6730600/ https://www.ncbi.nlm.nih.gov/pubmed/31544165 http://dx.doi.org/10.1136/bmjoq-2019-000695 |
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