B38-11 Bridging the Gap: Improving ED-to-MICU Transfers Through Standardized Criteria and Education

Abstract Introduction Delays in transferring critically ill patients from the emergency department (ED) to the medical intensive care unit (MICU) can worsen patient outcomes and contribute to ED overcrowding. Preliminary observations at our institution revealed variable awareness of MICU admission criteria among ED and MICU nurses and physicians, resulting in inconsistent referral decisions. This quality improvement (QI) initiative aimed to increase staff familiarity with MICU admission criteria and improve standardization of the ED-to-MICU transfer process. Methods A 7-month QI project was conducted at a tertiary academic medical center using iterative Plan-Do-Study-Act (PDSA) cycles. Baseline awareness of MICU admission criteria was assessed among ED and MICU physicians and nurses via a QR code-linked electronic survey. Interventions included targeted educational sessions, visual aids summarizing MICU admission criteria, and implementation of a standardized ED-to-MICU transfer checklist. Post-intervention awareness was reassessed using the same survey instrument. Outcomes included quantified self-reported familiarity with MICU criteria and utilization rate of the standardized transfer checklist. Data were analyzed using paired t-tests and descriptive statistics. Results Forty-two staff members (28 MICU, 14 ED) completed both pre- and post-intervention surveys. Mean familiarity scores with MICU criteria increased by 37% (3.0 ± 0.8 to 4.1 ± 0.6 on a 5-point Likert scale; p 0.001). Checklist utilization during transfers rose from 0% to 78%. Qualitative feedback identified improved clarity in triage decisions, communication, and workflow efficiency between ED and MICU teams. Conclusions A multifaceted intervention incorporating education, visual aids, and workflow standardization significantly improved provider awareness of MICU admission criteria and enhanced utilization of ED-to-MICU transfer checklists. QR code-based surveys provided a practical, low-cost mechanism for data collection and engagement across disciplines. Broader dissemination of standardized criteria and transfer tools may promote more consistent ICU triage decisions and improve patient safety across institutions. This abstract is funded by: None