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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Development and pilot implementation of a patient-oriented discharge summary for critically Ill patients
Anmol Shahid, Bonnie Sept, Shelly Kupsch, Rebecca Brundin-Mather, Danijela Piskulic, Andrea Soo, Christopher Grant, Jeanna Parsons Leigh, Kirsten M Fiest, Henry T Stelfox
Anmol Shahid, Bonnie Sept, Shelly Kupsch, Rebecca Brundin-Mather, Andrea Soo, Christopher Grant, Jeanna Parsons Leigh, Kirsten M Fiest, Henry T Stelfox, Department of Critical Care Medicine, University of Calgary, Calgary T2N 4Z6, Alberta, Canada
Danijela Piskulic, Department of Psychiatry, Hotchkiss Brain Institute, Calgary T2N 4Z6, Alberta, Canada
Jeanna Parsons Leigh, School of Health Administration, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada
Author contributions: Shahid A drafted the manuscript; all authors have contributed to the conception, design of this study, critically revised the manuscript and approved of the final submitted version.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki (1983). All methods were performed in accordance with the relevant guidelines and regulations by the University of Calgary Health Research Ethics Board, which granted institutional ethics approval for this study (18-1770). We also established a research agreement with the primary health custodian, Alberta Health Services (AHS) to permit us to conduct this study in the two identified ICUs and to access participant data via AHS health information systems.
Informed consent statement: Written informed consent was collected from all participants prior to the study enrollment.
Conflict-of-interest statement: There are no conflicts-of-interest to declare.
Data sharing statement: The dataset is available from the corresponding author at tstelfox@ucalgary.ca.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Anmol Shahid, BSc, PhD, Postdoctoral Fellow, Department of Critical Care Medicine, University of Calgary, McCaig Tower, Ground Floor, 3260 Hospital Drive NW, Calgary T2N 4Z6, Alberta, Canada. anmol.shahid1@ucalgary.ca
Received: March 1, 2022
Peer-review started: March 1, 2022
First decision: April 13, 2022
Revised: May 6, 2022
Accepted: June 18, 2022
Article in press: June 18, 2022
Published online: July 9, 2022
ARTICLE HIGHLIGHTS
Research background
Gaps in discharge communication can leave critically ill patients vulnerable to stress, poor health outcomes, and death. There are no standard written discharge summaries available for critically ill patients and their families.
Research motivation
Written discharge summaries can provide patients and their families with important information (e.g., medications, activity and diet restrictions, follow-up appointments, symptoms to expect, who to call if there are questions).
Research objectives
To develop and pilot test a patient-oriented discharge summary tool for critically ill patients and their families.
Research methods
We worked alongside former critically ill patients and their families, clinicians, and researchers to discuss patient needs and develop a written discharge summary tool. Intensive care unit nurses piloted the tool in two intensive care units in Calgary, Canada. Research team members administered follow-up surveys to patients, family participants, and ICU nurses on the impact of the summary tool on discharge.
Research results
Most participants felt the discharge summary tool was useful and informative. Most participants reported that they understood intensive care unit events and impacts on the patient’s health. Participating intensive care unit nurses reported time constraint in completing the discharge summary tool and encouraged refinement of the tool.
Research conclusions
The patient-oriented discharge summary tool could benefit from further refinement and testing in diverse critical care settings to better assess its feasibility and its effects on patient health outcomes.
Research perspectives
Written discharge communication provides patients and their families with essential information as they discharge from the intensive care unit. Future directions for a written patient-oriented discharge summary tool for critically ill patients include pairing the tool with earlier discharge practices and integrating the tool with electronic clinical information systems to fit better into the clinical workflow for ICU nurses.
