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Published on: August 25, 2014
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Standardized Transfer Process for a Neurointensive Care Unit and Assessment of Patient Bounceback
Cody L Nathan1, Laura Stein2, Lisa J George2
1Department of Neurology, University of Pennsylvania Health System, Philadelphia, PA, USA. cody.nathan@nm.org.
Neurocritical Care
|November 18, 2021
Summary
Implementing a standardized neuro-intensive care unit (neuro-ICU) transfer process improved provider-rated safety and identification of high-risk patients. However, it did not significantly decrease patient "bounceback" rates to the neuro-ICU.
Area of Science:
- Neurology
- Critical Care Medicine
- Patient Safety
Background:
- Patients readmitted to the intensive care unit (ICU) after transfer (
- bounceback") experience worse outcomes.
- Neuro-ICU bouncebacks are associated with increased mortality and prolonged hospital stays.
- Standardized transfer protocols aim to mitigate these risks.
Purpose of the Study:
- To develop and implement a multifaceted, standardized transfer process for neuro-ICU patients.
- To evaluate the impact of this process on provider-rated safety and the rate of neuro-ICU bouncebacks.
Main Methods:
- A five-step standardized transfer protocol was implemented in the neuro-ICU.
- Provider surveys assessed safety components before and after the intervention.
- Bounceback rates and patient disposition were analyzed using statistical tests.
Main Results:
- The standardized process reduced provider-rated concern for overall safety (p=0.008).
- Significant improvements were noted in transfer delays, high-risk patient identification, appropriate level of care assignment, and EMR handoff indicators.
- No statistically significant difference was observed in the patient bounceback rate (2.4% vs. 2.5%, p=1.00) or discharge disposition (p=0.553).
Conclusions:
- A standardized neuro-ICU transfer process enhances provider-rated safety and patient care coordination.
- Despite improvements in safety metrics, the implemented protocol did not reduce the neuro-ICU bounceback rate.
- Further research may be needed to identify strategies that effectively decrease bounceback rates.
