Critical Illness Clinical Trial
Official title:
A Cluster-specific Pre-post Trial With Randomized and Staggered Implementation to Evaluate the Effectiveness of an Electronic ICU Medical Transfer of Care Document to Improve Communication During ICU-to-Ward Transfers of Care
Verified date | October 2021 |
Source | University of Calgary |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The transfer of patients from the intensive care unit (ICU) to a medical or surgical hospital ward is a particularly high risk transfer that may expose patients to complications or adverse events if there are communication breakdowns between sending and receiving medical teams. Current dictation practice often falls short in producing optimal clinical documentation on patients being transferred from the ICU to the ward. The use of an electronic transfer of care tool to standardize communication may improve the quality of information exchanged between ICU and ward medical teams during ICU transfers, compared to dictation. This study will stagger implementation of a new electronic ICU medical transfer of care tool across four adult medical-surgical ICUs in one city. It is anticipated that the electronic ICU transfer tool will positively impact two inter-related goals: (1) improve the completeness and timeliness of clinical documentation on transfer, and (2) reduce the incidence of associated adverse patient clinical outcomes after transfer (e.g., adverse events, ICU readmission).
Status | Completed |
Enrollment | 1751 |
Est. completion date | September 15, 2021 |
Est. primary completion date | September 9, 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - medical-surgical ICU patient - ICU disposition on transfer is 'alive' - Transfer to another patient care unit Exclusion Criteria: - ICU discharge to home/community residence - ICU discharge by death |
Country | Name | City | State |
---|---|---|---|
Canada | Intensive Care Unit, Foothills Medical Centre | Calgary | Alberta |
Canada | Intensive Care Unit, Peter Lougheed Centre | Calgary | Alberta |
Canada | Intensive Care Unit, Rockyview General Hospital | Calgary | Alberta |
Canada | Intensive Care Unit, South Health Campus | Calgary | Alberta |
Lead Sponsor | Collaborator |
---|---|
Henry T. Stelfox, MD PhD | Alberta Health Services, Canadian Frailty Network, Canadian Institutes of Health Research (CIHR) |
Canada,
Parsons Leigh J, Brundin-Mather R, Whalen-Browne L, Kashyap D, Sauro K, Soo A, Petersen J, Taljaard M, Stelfox HT. Effectiveness of an Electronic Communication Tool on Transitions in Care From the Intensive Care Unit: Protocol for a Cluster-Specific Pre-Post Trial. JMIR Res Protoc. 2021 Jan 8;10(1):e18675. doi: 10.2196/18675. — View Citation
Parsons Leigh J, Brundin-Mather R, Zjadewicz K, Soo A, Stelfox HT. Improving transitions in care from intensive care units: Development and pilot testing of an electronic communication tool for healthcare providers. J Crit Care. 2020 Apr;56:265-272. doi: 10.1016/j.jcrc.2020.01.019. Epub 2020 Jan 18. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | ICU Readmission | Patient readmission to ICU after having been previously transferred from ICU to ward | Post patient ICU discharge, up to 72 hours | |
Other | Medical Emergency Team (MET) Activation | Patient experienced sudden clinical deterioration that triggered MET activation | Post patient ICU discharge, up to 72 hours | |
Other | Cardiac Arrest Event | Patient experienced a cardiac arrest event as recorded in hospital system by Code Blue team | Post patient ICU discharge, up to 72 hours | |
Other | Hospital Mortality | Patient died within hospital after ICU stay | Post patient ICU discharge, up to 60 days | |
Primary | Complete and Timely ICU medical transfer of care document | Binary measure of the presence/absence of two conditions (1) presence of four essential information elements in ICU transfer document (GOC designation, diagnosis, active health issues, and active medications), and (2) availability of the document to accepting medical team at the time of patient transfer. Both conditions must be met to be coded as present. | Day 1, post patient ICU discharge | |
Secondary | Overall completeness of ICU medical transfer of care document | Composite measure of presence of eight essential information fields in ICU transfer document | Day 1, post patient ICU-discharge | |
Secondary | Timeliness of ICU medical transfer of care document | Availability of ICU transfer of care document in the clinical information system | Day 1, post patient ICU discharge | |
Secondary | Quality Ratings of ICU clinicians | ICU clincian ratings of a sample of transfer of care documents. | 2 year | |
Secondary | Adverse Event | Adverse Event is defined as an injury or harm related to (or from) the delivery of care. A two-stage manual abstraction process based on the Institute for Healthcare Improvement Global Trigger Tool (GTT) method of chart review will be applied retrospectively to a random sample of patients. | Post patient ICU discharge, up to 72 hours | |
Secondary | Perceptions of ICU clinicians | Survey of ICU clinicians on preparing transfer of care document and perceptions of quality. | 2 year |
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