Before-After Study of a Checklist to Improve Acute Care to ICU Handoffs

Am J Med Qual. 2023 Jan-Feb;38(1):37-46. doi: 10.1097/JMQ.0000000000000091. Epub 2022 Nov 10.

Abstract

Transferring care of a patient is a critical process. The objective of this study was to evaluate a checklist to standardize handoffs from acute care to the intensive care unit (ICU). This was a single-center, before-after study of a checklist to standardize transfers of patients from acute care to the medical-cardiac ICU. Clinicians completed surveys about handoffs before and after checklist implementation. The association between study period and survey data was analyzed using multivariable logistic regression with cross-classified multilevel models. Surveys were completed by 179 clinicians. After checklist implementation, handoffs were more likely to occur in the ICU (OR 17.23; 95% CI, 1.81-164.19) and cover patient treatment preferences (OR 2.73; 95% CI, 1.12-6.66). However, checklist uptake was suboptimal (30% of responses indicated checklist use). Implementation of a checklist during acute care to ICU transfers is challenging. Signals suggesting process improvement warrant additional study.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Checklist
  • Controlled Before-After Studies
  • Critical Care
  • Humans
  • Intensive Care Units
  • Patient Handoff*