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Critically ill patients are at risk before admission and while in transition between areas in the hospital. This compromises patient safety, as the current structural approach limits optimal quality of care. The concept of a critical care transition team is one designed to improve patient outcomes outside the ICU where they are at increased risk. The concepts driving this initiative are improvements in patient safety, continuity of care, early intervention, team integration and cost effectiveness. Here will present our goals and the steps involved in development of the team.
St. Michael's Hospital general medical surgical ICU focuses on care for a marginalized population. In looking at the process of care, we determined that many ICUs have criteria for discharge and admission. What is not clear is how robust these criteria are in assessing patients at risk for emergent admissions that could be prevented. In our model, members of the critical care transition team will be available to intervene earlier than in a traditional medical consultation model.
An interdisciplinary group was formed based on interest, geography and specialty. Evaluation of the existing status was through chart review and group discussions to create the team's direction, focus and agenda. New processes and tools include standards, education and guidelines as well as organizational improvements. The integration of appropriate technology is part of this initiative. This team will develop a process in critical care that focuses on individual patient need across services beyond physical boundaries. Outcomes include extending critical care resources in a structured, systematic approach maximizing the skill and knowledge of all members of the interdisciplinary team. This project will improve resource utilization in critical care, and focus on shared decision-making thus enabling further work across structural boundaries to occur in the future.
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