Key result
Discharges at night or on weekends from the ICU were associated with increased rates of hospital readmission and mortality, while evidence for other transition practices remains inconclusive.
Why the study?
To map evidence on care transition components, practices, strategies, and tools during discharge from the ICU to the Inpatient Unit and their impact on adult patient outcomes.
What practices and strategies are used in the transition of care from the ICU to the inpatient unit, and how do they impact adult patient outcomes?
What practices and strategies are used in the transition of care from the ICU to the inpatient unit, and how do they impact adult patient outcomes?
Discharging patients from the ICU at night or on weekends is associated with increased readmission and mortality, highlighting the need for structured care transitions.
Night/weekend ICU discharges may warrant caution in planning; leaves open whether timing interventions improve outcomes.
OBJECTIVE: to map the available evidence on the components of the transition of care, practices, strategies, and tools used in the discharge from the Intensive Care Unit (ICU) to the Inpatient Unit (IU) and its impact on the outcomes of adult patients. METHOD: a scoping review using search strategies in six relevant health databases. RESULTS: 37 articles were included, in which 30 practices, strategies or tools were identified for organizing and executing the transfer process, with positive or negative impacts, related to factors intrinsic to the Intensive Care Unit and the Inpatient Unit and cross-sectional factors regarding the staff. The analysis of hospital readmission and mortality outcomes was prevalent in the included studies, in which trends and potential protective actions for a successful care transition are found; however, they still lack more robust evidence and consensus in the literature. CONCLUSION: transition of care components and practices were identified, in addition to factors intrinsic to the patient, associated with worse outcomes after discharge from the Intensive Care Unit. Discharges at night or on weekends were associated with increased rates of readmission and mortality; however, the association of other practices with the patient's outcome is still inconclusive.
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Weschenfelder et al. (2020) conducted a review in Discharge from Intensive Care Unit (n=37). Transition of care practices (including night or weekend discharge) was evaluated on Hospital readmission and mortality. Discharges at night or on weekends from the ICU were associated with increased rates of hospital readmission and mortality, while evidence for other transition practices remains inconclusive.
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