title: A two-site survey of clinicians to identify practices and preferences of intensive care unit transfers to general medical wards.
abstract: BACKGROUND
  The transfer of patients from the intensive care unit (ICU) to the general medical ward is high risk for adverse events and health care provider dissatisfaction. We aimed to identify perceived practices, and what information is important to communicate during an ICU transfer.
  
  
  METHODS
  This study used a self-administered questionnaire that surveyed physicians in 2 different hospitals. These physicians provide care in either the ICU or the general medical ward. Responses were evaluated with Likert scales and frequencies.
  
  
  RESULTS
  A total of 121 physicians (54% response rate) completed the survey. Current practice most often includes written chart and telephone communication. Most providers (63.3%) believed that the current process is inadequate. Surprises are common (79% of respondents); and reported adverse events include medication errors (60.4%), aspiration (49.5%), and decreased level of consciousness requiring intervention (44.6%). The use of an ICU transfer tool is one potential mechanism of improving this process of care, and providers reported several items that may be useful.
  
  
  CONCLUSIONS
  Providers reported the current process of transferring patients from the ICU to the general medical ward as inadequate. We highlight data that physicians feel is important to communicate at the time of transfer.
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA. Electronic address: mdetsky@mtsinai.on.ca.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Detsky
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, St Michael's Hospital, Toronto, Ontario, Canada. Electronic address: ailonj@smh.ca.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ailon
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada. Electronic address: weinerman@sunnybrook.ca.
authors.forename: Adina S
authors.initials: AS
authors.lastname: Weinerman
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: andrecarlos.amaral@sunnybrook.ca.
authors.forename: Andre C
authors.initials: AC
authors.lastname: Amaral
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada. Electronic address: cbell@mtsinai.on.ca.
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
mesh_terms: D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D007400:Interprofessional Relations; D008297:Male; D010360:Patient Transfer / Q000458:organization & administration*; D010362:Patients' Rooms; D017064:Process Assessment, Health Care; D011795:Surveys and Questionnaires
keywords: General medical ward; Intensive care unit; Process of care; Transfers