Enhancing Safety in Intra-Hospital Transport of Critically Ill Adults: An Evidence-Based Quality Improvement Project

Adverse events are very likely to occur during the intra-hospital transport of critically ill patients. Relevant guidelines have been issued at home and abroad, but the implementation rate of evidence-based guidelines by clinical medical staff is not high. How to continuously improve the quality of transport based on evidence is an urgent clinical problem.

The aim of this quality improvement (QI) project was to implement a change of practice based on the available evidence on the safety of intra-hospital transport.

Single-centre quasi-experimental study. This study was conducted at a tertiary comprehensive teaching hospital in Hubei. Practice changes were implemented, guided by the framework of evidence-based continuous quality improvement. A convenience sampling method was adopted to collect data on the implementation rate of review indicators, incidence of adverse events, scores of knowledge, attitude and practice of medical staff, as well as the satisfaction of patients and their families, by using checklists and questionnaires before and after clinical practice.

After quality improvement, the implementation rate of 22 review indicators increased from 0%-82.00% to 70.00%-100%, the incidence of adverse events decreased from 33.86% to 7.62%, the scores of medical staff's knowledge and practice questionnaire increased, and the satisfaction of patients and their families increased, all p < 0.05.

The utilisation of the best evidence in clinical practice can improve the safety of intra-hospital transport of critically ill patients and effectively reduce associated risks.

In the ICUs of patients requiring intra-hospital transportation, it may be recommended to improve clinical practices and processes guided by the theory of High Reliability Organisation and the framework of evidence-based continuous quality improvement to ensure patient safety and effectively reduce the incidence of adverse events.