Grant: Embedded Clinician Researcher Salary Award - Western Canada

When patients are transferred from one care setting to another there is a high risk of error. The discharge of patients from the intensive care unit (ICU) is an example of a high-risk transfer. These are the sickest and most complex patients. For the past four years I have led a team of professionals and interested citizens to re-design the transition of care for patients discharged from intensive care. We are making good progress, but have stumbled upon an unexpected and important observation that we believe needs to be urgently addressed. Patients are being discharged directly from the ICU to the community! Traditionally, discharge from the ICU has been a two-step process; transition to a 'regular' hospital ward for a period of care, rehabilitation and assessment, and then return to the community (e.g., home). However, because of growing demands on our healthcare system, patients are being discharged directly from the ICU to the community. In 2014, 1 in 10 adult ICU patients in Alberta were directly discharged to the community! This new approach offers potential advantages (e.g., could be more efficient) and disadvantage (e.g., might not be as safe), but we don't know because it has not been studied. In direct response to this challenge, I propose to expand my team's work to re-design the transition of care for patients discharged from intensive care and develop an evidence-informed 'ICU discharge tool kit' that supports all patients - those who receive care on a hospital ward before leaving hospital and those that return directly to the community. This tool kit will be similar to the World Health Organization's Surgical Safety Checklist, and will be designed to ensure that the right patient is discharged at the right time to the right setting with the right care plan.