Post-intensive care unit in-hospital ward stay Other
Conditions
Interventions
Mixed methods exploratory study comprising four sub-studies:
A. Retrospective Case Record Review (deceased patients)
Human factors-focused review of medical notes of patients who were discharged from
Sponsors
University of Oxford
Eligibility
Sex/Gender
All
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Participant group by sub-study: A. RCRR (deceased patients): Patients discharged from ICU to wards who subsequently died before hospital discharge. B. Patient and relative interviews and focus groups: 1. Patients discharged from ICU to a ward and subsequently discharged out of hospital 2. Relatives of patients who survived their post-ICU ward stay 3. Relatives of patients who died following ICU discharge before hospital discharge Participants will be sought with varying experiences, to facilitate maximum variation in the sample (76) C. Staff interviews/focus groups: Staff involved in the care of patients discharge from intensive care to wards (including nurses, doctors, physiotherapists, dieticians and other allied health professionals). As above, purposive sampling will be utilised to ensure a diverse range of exposure, experience and background training. D. RCRR (survivors): Patients discharged from ICU to a ward and subsequently discharged out of hospital. Ideally including some of those interviewed as above Inclusion criteria by sub-study: A. RCRR (deceased): 1. Male or female, aged 18 years or over 2. Patient discharged from ICU to a ward and died prior to hospital discharge B. Patient/relative interviews: 1. Participant is willing and able to give informed consent for participation in the study 2. Male or female, aged 18 years or over 3. Patient or relative of patient who was discharged from ICU to a ward and survived to hospital discharge, or relative of patient who was discharged from ICU and did not survive to hospital discharge C. Staff interviews/focus groups: 1. Participant is willing and able to give informed consent for participation in the study 2. Male or female, aged 18 years or over 3. A member of NHS staff involved in the care of patients discharged from ICU to wards D. RCRR (survivors): 1. Participant is willing and able to give informed consent for participation in the study 2. Male or female, aged 18 years or over 3. Discharged from ICU to a ward and subsequently discharged from hospital
Exclusion criteria
Exclusion criteria: The participant may not enter the study if ANY of the following apply: A. RCRR (deceased): 1. Inaccessible medical notes (all efforts will be made to obtain access to medical notes, but these are occasionally misplaced within the hospital system, or are unavailable due to investigation of an ongoing complaint) B. Patient/relatives interviews/focus groups: 1. Lack of capacity to consent 2. Poor spoken English (it will not be possible to conduct the interviews through an interpreter) C. Staff focus groups: 1. Does not meet inclusion criteria D. RCRR (survivors): 1. Does not meet inclusion criteria
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| As this is a mixed methods exploratory study, the outcomes are not as clearly defined as in an interventional study. The primary objective is to develop a multifaceted human factors based intervention to reduce in-hospital mortality rates in patients who have been discharged from intensive care. The primary outcome measure is the intervention plan which will be delivered at the end of the study. | — |
Secondary
| Measure | Time frame |
|---|---|
| A. Retrospective case record review (RCRR) (deceased patients): identify examples of high quality care and areas for improvement from medical records of deceased patients Outcome measure: Aspects of care identified and the human factors-based factors which contributed B. Interview study (patients and relatives): identify examples of high quality care and areas for improvement from patients’ and relatives’ perspective Outcome measure: Aspects of care identified C. Interview/focus groups study (staff): identify examples of high quality care and areas for improvement from staff perspective Outcome measure: Aspects of care identified and potential approaches identified by patients D. Retrospective case record review (survivors): identify examples of high quality care and areas for improvement from medical records of survivors Outcome measure: Aspects of care identified and the human factors-based factors which contributed All secondary outcome measures will be assessed at the end of primary data collection period, prior to intervention design (12 months into the study). | — |
Countries
England, United Kingdom
Contacts
Public ContactSarah Vollam
Outcome results
None listed