Key result
ICU discharge readiness checklist associates with better patient safety culture in 4 dimensions versus control.
Why the study?
Discharging ICU patients carries risks for adverse events, and there was a critical gap regarding the impact of an ICU discharge readiness checklist on patient safety culture.
Does implementing an ICU discharge readiness checklist improve patient safety culture among ICU healthcare providers?
Does implementing an ICU discharge readiness checklist improve patient safety culture among ICU healthcare providers?
Implementing an ICU discharge readiness checklist may improve specific dimensions of patient safety culture among healthcare providers.
May improve select ICU safety culture dimensions; leaves open broader adoption pending randomized trials.
Background: Discharging patients from intensive care units (ICUs) poses significant risks for adverse events (AEs), contributing to hospital morbidity and mortality. To mitigate premature transitioning, an ICU discharge readiness checklist (ICU-DRC) was developed. Enhanced patient safety culture (PSC) is crucial for reducing AEs and improving outcomes. Given the pressing need to enhance PSC in ICUs, this study evaluates the impact of ICU-DRC implementation on PSC, aiming to address a critical gap in quality improvement. Methods: A prospective quasi-experimental study assessed PSC before and after a year-long ICU-DRC intervention at Merkur Clinical Hospital in Zagreb, Croatia. Healthcare providers from two distinct ICUs participated voluntarily in the Hospital Survey on Patient Safety Culture. The surgical ICU, where the intervention was applied, employed 106 providers, while the medical ICU, which did not implement the intervention, had 42 providers. Results: Initial response rates were 58% for the intervention group and 45% for the control group, with post-intervention rates of 53% and 48%, respectively. The ICU-DRC was utilized with a fidelity of 65.7%. Due to the non-normal distribution found for most variables, non-parametric analytical procedures were applied. In baseline measurements, the control group outperformed the intervention group in three out of fourteen PSC dimensions. Post-intervention, PSC scores in the intervention group significantly improved in one dimension, whereas three dimensions in the control group showed significant declines, resulting in superior PSC outcomes for four dimensions in the intervention group during the second measurement. Conclusions: Applying the ICU-DRC as an isolated safety intervention aimed at optimizing ICU patient throughput resulted in observable patterns of improvement in several PSC dimensions, with statistically significant changes in specific areas.
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Vončina et al. (2025) studied Patient safety culture in ICUs (n=148). ICU discharge readiness checklist (ICU-DRC) vs. No intervention (medical ICU) was evaluated on Patient safety culture (PSC) dimensions. Implementing an ICU discharge readiness checklist significantly improved patient safety culture in 1 dimension, resulting in superior outcomes for 4 of 14 dimensions compared to the control group.
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