Contextual Factors Influencing Intensive Care Patients' Discharge Processes: A Multicentre Prospective Observational...

Area of Science:

• Critical Care Medicine
• Healthcare Management
• Patient Flow Optimization

Background:

• Discharge processes from intensive care units (ICUs) are complex and can be influenced by various factors.
• Delays and after-hours discharges are recognized issues impacting patient care quality and hospital efficiency.

Purpose of the Study:

• To compare contextual factors influencing discharge practices across three different intensive care units (ICUs).
• To identify variations in discharge process timelines and their potential causes.

Main Methods:

• A prospective observational study design was employed.
• Data on patient discharge processes were collected using a discharge process report form (DPRF) from May to September 2023.
• Descriptive statistics and one-way analysis of variance (ANOVA) were used to analyze demographic, clinical, and time interval data.

Main Results:

• Out of 69 observed patient discharge processes, 59% experienced delays, and 20% had after-hours discharges.
• Significant differences in mean discharge time intervals were observed among the three hospitals.
• Hospital C showed the longest delays, particularly in ward bed readiness (31.9 hours) and post-nurse preparation discharge (26.7 hours).

Conclusions:

• Discharge delays and after-hours discharges are prevalent issues in ICUs.
• Significant variations in discharge process timings exist between different hospital settings.
• Context-specific interventions are crucial to optimize ICU discharge processes, reduce delays, and enhance patient care quality and safety.